• Tomoki Wada, Hideo Yasunaga, Ryota Inokuchi, Hiroki Matsui, Takehiro Matsubara, Yoshihiro Ueda, Masataka Gunshin, Takeshi Ishii, Kent Doi, Yoichi Kitsuta, Susumu Nakajima, Kiyohide Fushimi, and Naoki Yahagi.
• Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan. Electronic address: wadat-eme@h.u-tokyo.ac.jp.
• J Crit Care. 2015 Dec 1; 30 (6): 1227-31.

PurposeWe investigated whether surgical rib fixation improved outcomes in patients with traumatic rib fractures.Materials And MethodsThis 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.ResultsAmong 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).ConclusionsSurgical rib fixation within 10 days of hospital admission may improve outcomes in patients with traumatic rib fractures.Copyright © 2015 Elsevier Inc. All rights reserved.

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