No difference in mortality between level I and level II trauma centers performing surgical stabilization of rib fracture

Wendy Y Rockne; Areg Grigorian; Ashton Christian; Jeffry Nahmias; Michael Lekawa; Matthew Dolich; Theresa Chin; Sebastian D Schubl

doi:10.1016/j.amjsurg.2020.09.033

No difference in mortality between level I and level II trauma centers performing surgical stabilization of rib fracture

Am J Surg. 2021 May;221(5):1076-1081. doi: 10.1016/j.amjsurg.2020.09.033. Epub 2020 Sep 26.

Authors

Wendy Y Rockne¹, Areg Grigorian², Ashton Christian³, Jeffry Nahmias⁴, Michael Lekawa⁵, Matthew Dolich⁶, Theresa Chin⁷, Sebastian D Schubl⁸

Affiliations

¹ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
² University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
³ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
⁴ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
⁵ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
⁶ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
⁷ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].
⁸ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: [email protected].

PMID: 33010876
DOI: 10.1016/j.amjsurg.2020.09.033

Abstract

Background: A comparison of outcomes between Level I (LI) and Level II (LII) Trauma Centers (TCs) performing surgical stabilization of rib fracture (SSRF) has not been well described. We sought to compare risk of mortality for patients undergoing SSRF between LI and LII TCs.

Methods: The Trauma Quality Improvement Program was queried for patients presenting with rib fracture to LI or LII TCs from 2010 to 2015. A multivariable logistic regression analysis was performed.

Results: 14,046 (7.1%) of 199,020 patients with rib fractures underwent SSRF. SSRF increased from 1304 in 2010 to 3489 in 2015: a geometric mean annual increase of 22%. LI TCs demonstrated a mortality incidence of 1.6% while LII TCs demonstrated a mortality incidence of 1.5% (p > 0.05). There was no statistically significant difference in risk of mortality after SSRF between LI and LII TCs (odds ratio 1.12, confidence interval 0.79-1.59, p-value 0.529).

Conclusions: Patients undergoing SSRF at LI and LII TCs have no significant difference in risk of mortality. Additionally, there is an annually growing trend across all centers in SSRF performed both for flail and non-flail segments.

Keywords: Level I Trauma center; Non-flail segment; Rib fracture; Surgical stabilization of rib fracture.

Publication types

Comparative Study

MeSH terms

Adult
Female
Fracture Fixation, Internal / adverse effects
Fracture Fixation, Internal / mortality*
Fracture Fixation, Internal / statistics & numerical data
Humans
Injury Severity Score
Male
Middle Aged
Rib Fractures / mortality
Rib Fractures / surgery*
Risk Factors
Trauma Centers / standards
Trauma Centers / statistics & numerical data*