The ribs or not the ribs: which influences mortality?

BackgroundThe relative impact of rib fractures on mortality risk is unclear. This study examined the respective relationships between mortality and the number of fractured ribs, patient age, and severity of intrathoracic and extrathoracic injuries.MethodsThe National Trauma Data Bank was queried, abstracting mortality, age, number of ribs fractured, associated intrathoracic and extrathoracic injury, and Abbreviated Injury Score codes.ResultsMultivariate logistic regression indicated the strongest influence on mortality was severity of intrathoracic injury, followed by severity of extrathoracic injury, age 65 years or older, more than 5 ribs fractured, and age 46 to 65 years. The mortality rate for isolated rib fractures ranged from 1.8% to 3.2%.ConclusionsMortality related to rib fractures is affected independently by severe intrathoracic injury, presence of extrathoracic injury, advanced age, and more than 5 fractured ribs. Patients with these conditions may benefit from a higher level of care.