• Am. J. Surg. · Mar 2021

    Attention to detail: A dedicated rib fracture consultation service leads to earlier operation and improved clinical outcomes.

    • Christina Riojas, Kyle W Cunningham, John M Green, Gaurav Sachdev, Samuel W Ross, Cynthia W Lauer, and Bradley W Thomas.
    • FH "Sammy" Ross Trauma Center, Department of Surgery, Carolinas Medical Center, NC.1000 Blythe Boulevard, Charlotte, NC, 28203, United States.
    • Am. J. Surg. 2021 Mar 26.

    BackgroundSurgical stabilization of rib fractures (SSRF) has been correlated with improved outcomes, including decreased length of stay (LOS). We hypothesized that an SSRF consultation service would increase the frequency of SSRF and improve outcomes.MethodsA prospective observational study was performed to compare outcomes before and after implementing an SSRF service. Primary outcome was time from admission to surgery; secondary outcomes included LOS, mortality and morphine milligram equivalents (MME) prescribed at discharge.Results1865 patients met consultation criteria and 128 patients underwent SSRF. Mortality decreased (6.3% vs. 3%) and patients were prescribed fewer MME at discharge (328 MME vs. 124 MME) following implementation. For the operative cohort, time from admission to surgery decreased by 1.72 days and ICU LOS decreased by 2.6 days.ConclusionEstablishment of an SSRF service provides a mechanism to maximize capture and evaluation of operative candidates, provide earlier intervention, and improve patient outcomes. Additional study to determine which elements and techniques are most beneficial is warranted.Level Of EvidenceIII.Copyright © 2021. Published by Elsevier Inc.

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