Factors associated with discharge to home after traumatic rib fractures.

Abstract

Chest wall injury is common among trauma patients. Generally, patients with more medical problems tend to have worse outcomes with rib fractures. Our aim was to determine if surgical stabilization of rib fractures (SSRF) increases the likelihood of discharge to home. We performed a retrospective cohort study of patients with ≥1 comorbidity, aged 18-99 with rib fractures from five Chest Wall Injury Society (CWIS) Collaborative Centers. Discharge disposition of patients who underwent SSRF was compared to those who did not undergo surgery. Discharge to home was considered the ideal state to which other discharge dispositions were compared. For the model to estimate discharge to a rehabilitation hospital or skilled nursing facility, a multivariable logistic regression analysis was performed. 790 patients with ≥1 comorbidities and rib fractures were identified, and 545 (61.8 %) patients were discharged to home. Logistic regression analysis demonstrated SSRF (0.33 (0.15 - 0.75)) and tobacco use (0.62 (0.39 - 0.96)) were independently associated with discharge to home. In patients with rib fractures and at least one comorbid condition, SSRF is associated with discharge to home. Counterintuitively, tobacco use was also associated with discharge to home. Level II STUDY TYPE: Therapeutic/Care Management.