Evaluation of patients with surgically stabilized rib fractures by different scoring systems

• DOI: 10.1007/s00068-018-0999-3
• Publication Date: 2018-08-21T15:26:03Z
• Authors: Joanna Wycech; Alexander Alexei ...; Ivan Puente
• Keywords: Adult; Aged, 80 and over; Male; Rib Fractures; Thoracic Injuries; Fractures, Multiple; Contusions; Patient Selection; Clinical Decision-Making; Age Factors; Lung Injury; Middle Aged; Conservative Treatment; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Case-Control Studies; Flail Chest; Humans; Female; Aged; Retrospective Studies

Surgical Stabilization (SSRF) is gaining popularity as an alternative to non-operative management (NOM) of patients with rib fractures, however, there are no established guidelines for patients' quantifiable evaluation and for SSRF recommendation. Known rib scoring systems include: Rib Fracture Score (RFS), Chest Wall Trauma Score (CWTS), Chest Trauma Score (CTS) and RibScore (RS), but are underutilized. The purpose was to provide values of scoring systems in SSRF and NOM patients and correlate them with treatment assignment.Retrospective cohort study included 87 SSRF and 87 propensity matched NOM patients from two level-1 trauma centers. Clinical variables and score values were compared between two groups.SSRF compared to NOM patients had significantly higher number of total rib fractures, displaced fractures, rates of pulmonary contusion and flail chest. RS and CTS values were significantly higher in SSRF compared to NOM patients (2.3 vs. 1.7, p = 0.001; 5.8 vs. 5.3, p = 0.005, respectively), but RFS and CWTS were similar.Application of scoring systems could help with patients' objective and standardized assessment and may aid in treatment decisions. RibScore was superior to other scoring systems.