Demographics, injury-related characteristics and interventions of patients with traumatic rib fractures
| Variable | Total cohort | Polytrauma (ISS >16) | Elderly (>65 years) | Isolated thoracic trauma | Flail chest | Type of injury | |||||
| Yes | No | Yes | No | Yes | No | Yes | No | Blunt | Penetrating | ||
| All, no. (%) | 564 798 | 253 564 (44.9) | 311 234 (55.1) | 161 579 (28.6) | 403 219 (71.4) | 350 898 (62.1) | 213 900 (37.8) | 23 388 (4.1) | 541 410 (95.9) | 539 422 (95.5) | 16 179 (2.9) |
| Age at trauma | 53 (39–67) | 50 (34–63) | 56 (43–70) | 76 (70–82) | 46 (33–55) | 350 898 | 50 (34–64) | 55 (45–66) | 53 (39–67) | 54 (40–67) | 29 (23–41) |
| Male sex | 390 101 (69.1) | 180 082 (71.0) | 210 019 (67.5) | 90 521 (56.0) | 299 580 (74.3) | 241 872 (68.9) | 148 033 (69.3) | 17 528 (74.9) | 372 573 (68.8) | 368 796 (63.4) | 14 481 (89.5) |
| Mechanism of injury | |||||||||||
| Motor vehicle accident | 237 995 (51.6) | 130 039 (62.4) | 107 956 (42.6) | 49 591 (38.1) | 188 404 (56.9) | 128 905 (45.1) | 109 090 (62.0) | 11 458 (60.3) | 226 537 (51.2) | 237 995 (54.6) | 0 (0) |
| Fall from height/stairs | 129 577 (28.1) | 38 618 (18.5) | 90 939 (35.9) | 67 675 (51.9) | 61 882 (18.7) | 92 781 (32.5) | 36 776 (20.9) | 3974 (21.0) | 125 583 (28.4) | 129 577 (29.7) | 0 (0) |
| Pedestrian | 11 955 (2.6) | 4777 (2.3) | 7178 (2.8) | 2078 (1.6) | 9877 (3.0) | 8215 (2.9) | 3740 (2.1) | 518 (2.7) | 11 437 (2.6) | 11 955 (2.7) | 0 (0) |
| Assault | 16 173 (3.5) | 8611 (4.1) | 7562 (3.0) | 499 (0.4) | 15 674 (4.7) | 10 213 (3.6) | 5960 (3.4) | 78 (0.4) | 16 095 (3.6) | 0 (0) | 16 173 (100) |
| Struck-by | 16 819 (3.6) | 5593 (2.7) | 11 226 (4.4) | 2045 (1.6) | 14 774 (4.5) | 12 166 (4.3) | 4653 (2.6) | 523 (2.8) | 16 296 (3.7) | 16 819 (3.9) | 0 (0) |
| Other | 49 049 (10.6) | 20 738 (10.0) | 28 311 (11.2) | 8399 (6.4) | 40 650 (12.3) | 33 224 (11.6) | 15 825 (9.0) | 2457 (12.9) | 46 592 (10.5) | 39 846 (9.1) | 0 (0) |
| Type of injury | |||||||||||
| Blunt | 539 422 (95.5) | 241 344 (95.2) | 298 078 (95.8) | 159 344 (98.6) | 380 078 (94.3) | 334 500 (95.3) | 204 922 (95.8) | 22 904 (97.9) | 516 518 (95.4) | 539 422 (100) | 0 (0) |
| Penetrating | 16 179 (2.9) | 8615 (3.4) | 7564 (2.4) | 500 (0.3) | 15 679 (3.9) | 10 261 (2.9) | 5963 (2.8) | 78 (0.01) | 16 101 (3.0) | 0 (0) | 16 179 (100) |
| AIS | |||||||||||
| Head | 0 (0–1) | 0 (0–3) | 0 (0–0) | 0 (0–1) | 0 (0–2) | 0 (0–0) | 2 (0–4) | 0 (0–0) | 0 (0–1) | 0 (0–2) | 0 (0–0) |
| Thorax | 3 (2–3) | 3 (3–4) | 3 (2–3) | 3 (2–3) | 3 (2–4) | 3 (2–3) | 2 (2–4) | 3 (3–4) | 3 (2–3) | 3 (2–3) | 3 (3–4) |
| Abdomen | 0 (0–1) | 0 (0–2) | 0 (0–0) | 0 (0–0) | 0 (0–1) | 0 (0–0) | 0 (0–3) | 0 (0–2) | 0 (0–1) | 0 (0–1) | 0 (0–2) |
| Extremities | 0 (0–2) | 0 (0–2) | 0 (0–0) | 0 (0–2) | 0 (0–2) | 0 (0–0) | 1 (0–3) | 1 (0–2) | 0 (0–2) | 0 (0–2) | 0 (0–1) |
| ISS | 14 (9–22) | 22 (18–29) | 10 (8–13) | 13 (9–18) | 14 (10–22) | 10 (9–14) | 22 (17–29) | 24 (17–33) | 14 (9–21) | 14 (9–22) | 17 (10–26) |
| Polytrauma (ISS >16) | 253 564 (44.9) | 253 564 (100) | 0 (0) | 56 704 (35.1) | 196 860 (48.8) | 76 466 (21.8) | 177 098 (82.8) | 18 227 (77.9) | 255 044 (43.5) | 241 344 (95.3) | 298 078 (95.8) |
| GCS | 15 (15–15) | 15 (13–15) | 15 (15–15) | 15 (15–15) | 15 (15–15) | 15 (15–15) | 15 (14–15) | 15 (10–15) | 15 (15–15) | 15 (15–15) | 15 (12–15) |
| Comorbidity | |||||||||||
| Congestive heart failure | 14 692 (2.6) | 4657 (1.8) | 10 035 (3.2) | 11 115 (6.9) | 3577 (0.9) | 10 319 (2.9) | 4373 (2.0) | 474 (2.0) | 14 218 (2.6) | 14 485 (2.7) | 62 (0.4) |
| Hypertension | 170 045 (30.1) | 63 762 (25.1) | 106 283 (34.1) | 91 395 (56.6) | 78 650 (19.5) | 115 550 (32.9) | 54 473 (25.5) | 7298 (31.2) | 162 747 (30.1) | 166 539 (30.8) | 1259 (7.8) |
| Diabetes mellitus | 69 798 (12.4) | 26 593 (10.5) | 43 205 (13.9) | 35 766 (22.1) | 34 032 (8.4) | 47 111 (13.4) | 22 687 (10.6) | 3123 (13.4) | 66 675 (12.3) | 68 482 (12.7) | 443 (2.7) |
| Respiratory disease | 42 764 (7.6) | 15 221 (6.0) | 27 543 (8.8) | 20 250 (12.5) | 22 514 (5.6) | 29 956 (8.5) | 12 808 (6.0) | 1811 (7.7) | 40 953 (7.6) | 41 465 (7.7) | 631 (3.9) |
| Obesity | 30 621 (5.4) | 14 734 (5.8) | 15 887 (5.1) | 7992 (4.9) | 22 629 (5.6) | 18 573 (5.3) | 12 048 (5.6) | 1765 (7.5) | 28 856 (5.3) | 29 946 (5.6) | 395 (2.4) |
| Smoker | 96 579 (17.1) | 42 469 (16.7) | 54 110 (17.4) | 11 319 (7.0) | 85 155 (21.1) | 61 515 (17.5) | 35 064 (16.4) | 3678 (15.7) | 92 901 (17.2) | 91 716 (17.0) | 3123 (0.0) |
| Number of rib fractures | |||||||||||
| 1 | 116 689 (21.6) | 36 984 (15.7) | 79 705 (26.0) | 27 748 (17.9) | 88 941 (23.0) | 71 636 (21.2) | 45 053 (22.2) | – | 116 689 (21.6) | 105 076 (20.3) | 9401 (58.4) |
| 2 | 88 243 (16.3) | 29 200 (12.4) | 59 043 (19.3) | 24 835 (16.0) | 63 408 (16.4) | 56 649 (14.7) | 31 594 (15.6) | – | 88 243 (16,3) | 83 072 (16.1) | 3617 (22.5) |
| 3 | 69 765 (12.9) | 27 988 (11.9) | 41 777 (13.4) | 22 003 (14.2) | 47 762 (12.4) | 47 023 (12.2) | 22 742 (11.2) | – | 69 765 (12.9) | 67 518 (13.1) | 1115 (6.9) |
| 4 | 75 373 (13.9) | 35 792 (15.2) | 39 581 (12.9) | 23 077 (14.9) | 52 296 (13.5) | 50 054 (12.9) | 25 319 (12.5) | – | 75 373 (13.9) | 73 678 (14.3) | 561 (3.5) |
| 5 | 41 466 (7.7) | 19 928 (8.5) | 21 538 (7.0) | 12 807 (8.3) | 28 659 (7.4) | 27 354 (7.1) | 14 112 (7.0) | – | 41 466 (7.7) | 40 681 (7.9) | 198 (1.2) |
| >6 | 149 874 (27.7) | 85 332 (36.3) | 64 429 (21.1) | 44 386 (28.7) | 105 488 (27.3) | 133 838 (34.6) | 64 150 (31.6) | – | 149 758 (26.5) | 146 493 (28.4) | 1209 (7.5) |
| Flail chest | 23 388 (4.1) | 18 227 (7.2) | 5161 (1.7) | 6723 (4.2) | 16 665 (4.1) | 12 458 (3.6) | 10 861 (5.1) | 23 388 (100) | 0 (0) | 22 904 (4.2) | 78 (0.5) |
| Open rib fractures | 11 433 (2.0) | 6776 (2.7) | 4657 (1.5) | 444 (0.3) | 10 969 (2.7) | 6879 (2.0) | 4554 (2.1) | 31 (0.1) | 11 402 (2.1) | 2643 (0.5) | 8680 (53.6) |
| Concomitant injuries | |||||||||||
| Pulmonary contusion | 143 096 (25.3) | 90 926 (35.9) | 52 170 (16.8) | 24 659 (15.3) | 118 437 (29.4) | 78 102 (22.3) | 64 994 (30.4) | 11 256 (48.1) | 131 840 (24.4) | 138 792 (25.7) | 2364 (14.6) |
| Pneumothorax | 148 216 (26.2) | 78 287 (30.9) | 69 929 (22.5) | 30 679 (19.0) | 117 537 (29.1) | 91 874 (26.2) | 56 342 (26.3) | 8756 (37.4) | 139 460 (25.8) | 144 418 (26.8) | 1270 (7.8) |
| Hemothorax | 35 898 (6.4) | 21 114 (8.3) | 14 784 (4.8) | 10 944 (6.8) | 24 954 (6.2) | 21 166 (6.0) | 14 732 (6.9) | 3513 (15.0) | 32 385 (6.0) | 34 298 (6.4) | 1020 (6.3) |
| Sternum fracture | 43 134 (7.6) | 25 162 (9.9) | 17 972 (5.8) | 14 308 (8.9) | 28 826 (7.1) | 24 202 (6.9) | 18 932 (8.9) | 2680 (11.5) | 40 454 (7.5) | 42 368 (7.9) | 342 (2.1) |
| Interventions | |||||||||||
| Epidural analgesia | 2505 (0.4) | 1202 (0.4) | 1303 (0.4) | 890 (0.5) | 1615 (0.4) | 1834 (0.5) | 671 (0.3) | 332 (1.4) | 2173 (0.4) | 2456 (0.5) | 7 (0.01) |
| Thoracotomy | 4397 (0.8) | 3427 (1.4) | 970 (0.3) | 698 (0.4) | 3699 (0.9) | 2060 (0.6) | 2337 (1.1) | 658 (2.8) | 3739 (0.7) | 3210 (0.6) | 1130 (7.0) |
| Rib fixation | 25 338 (4.5) | 17 102 (6.8) | 8236 (2.6) | 3655 (2.3) | 21 683 (5.4) | 11 052 (3.5) | 14 286 (6.7) | 2939 (12.6) | 22 399 (4.1) | 24 966 (4.6) | 147 (0.9) |
All categorical and dichotomous variables are presented as number (%).
All continuous variables are presented as median (IQR).
*Numbers may not add up to total number of patients due to missing values.
AIS, Abbreviated Injury Scale; GCS, Glasgow Coma Scale; ISS, Injury Severity Score; No., Number.