Effectiveness of surgical rib fixation on prolonged mechanical ventilation in patients with traumatic rib fractures: A propensity score-matched analysis

J Crit Care. 2015 Dec;30(6):1227-31. doi: 10.1016/j.jcrc.2015.07.027. Epub 2015 Aug 1.


Purpose: We investigated whether surgical rib fixation improved outcomes in patients with traumatic rib fractures.

Materials and methods: This was a retrospective study using a Japanese administrative claim and discharge database. We included patients with traumatic rib fractures admitted to hospitals where surgical rib fixation was available from July 1 2010, to March 31, 2013. We detected patients who underwent surgical rib fixation within 10 days of hospital admission (surgical group) and those who did not (control group). The main outcome was prolonged mechanical ventilation, defined as that performed for 5 or more days, or death within 28 days. One-to-four propensity score matching was performed between the 2 groups with adjustment for possible confounders.

Results: Among 4577 eligible patients, 90 (2.0%) underwent the surgical rib fixation. After the matching, we obtained 84 and 336 patients in the surgical and control groups, respectively. Logistic regression analyses showed that the surgical group was significantly less likely to receive prolonged mechanical ventilation or die within 28 days than the control group (22.6% vs 33.3%; odds ratio, 0.59; 95% confidence interval, 0.36-0.96; P=.034).

Conclusions: Surgical rib fixation within 10 days of hospital admission may improve outcomes in patients with traumatic rib fractures.

Keywords: Cohort study; Diagnosis Procedure Combination database; Propensity score matching; Surgical rib fixation; Survival analysis; Traumatic rib fracture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Female
  • Fracture Fixation, Internal*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Propensity Score
  • Respiration, Artificial / statistics & numerical data*
  • Retrospective Studies
  • Rib Fractures / surgery*
  • Young Adult