A decade of surgical stabilization of rib fractures: the effect of study year on patient selection, operative characteristics, and in-hospital outcome

• Published in: Injury 2022-05, Vol.53 (5), p.1637-1644
• Main Authors: Prins, Jonne T.H., Leasia, Kiara, Sauaia, Angela, Burlew, Clay C., Cohen, Mitchell J., Coleman, Jamie J., Lawless, Ryan A., Platnick, K. Barry, Werner, Nicole L., Wijffels, Mathieu M.E., Moore, Ernest E., Pieracci, Fredric M.
• Format: Article
• Language: English
• Subjects: Learning curve; Operative time; Outcome; Rib fracture; Study year; Surgical stabilization of rib fractures
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.12.003

•Intra-operative characteristics and in-hospital outcomes after SSRF changed significantly over the years.•In-hospital outcomes improved over the decade that SSRF has been implemented.•Operative time and time per plate fixated increased over the study period.•When evaluating outcomes after SSRF, it is suggested to account for study year. Many centers now perform surgical stabilization of rib fractures (SSRF). This single center study aimed to investigate temporal trends by year in patient selection, operative characteristics, and in-hospital outcomes We hypothesized that, over time, patient selection, time to SSRF, operative time, and in-hospital outcomes varied significantly. A retrospective review of a prospectively maintained SSRF database (2010 to 2020) was performed. Patients were stratified by year in which they underwent SSRF. The primary outcome was operative time, defined in minutes from incision to closure. Secondary outcomes were patient and operative characteristics, and in-hospital outcomes. Multivariable regression analyses were performed to assess for temporal trends, corrected for confounders. The outcomes ventilator-, Intensive Care Unit-, and hospital-free days (VFD, IFD, and HFD, respectively) were categorized based on the group's medians, and complications were combined into a composite outcome. In total, 222 patients underwent SSRF on a median of one day after admission (P25-P75, 0-2). Patients had a median age of 54 years (P25-P75, 42-63), ISS of 19 (P25-P75, 13-26), RibScore of 3 (P25-P75, 2-5), and sustained a median of 8 fractured ribs (P25-P75, 6-11). In multivariable analysis, increasing study year was associated with an increase in operative time (p