Traumatic rib fracture: Important contributors to morbidity and mortality

Background: Traumatic rib fracture (TRF) significantly impacts on patients and predicts mortality. We sought to identify the important causes of morbidity and mortality in patients with TRF in Nigeria. Methods: This study was a prospective observational cohort study of patients with TRF following blunt chest trauma admitted to two hospitals for 4 years. Patients were analyzed according to age, gender, cause of trauma, nature of chest injury, presence of significant subcutaneous emphysema (SE), associated injuries, injury severity scores, and 30-day mortality. Predictors of survival were determined by multiple regression analyses. Results: The 30-day mortality rate was 8.2%. When the relationship between outcome of rib fracture and some study variables were compared; most of the patients who died had SE (P = 0.018), bilateral chest affected (P = 0.002), lung contusion (P = 0.033), and associated injury (P = 0.028). Multiple regression analysis showed some variables as significant contributors of mortality due to rib facture as patients with SE were about 9.5 times more likely to die of rib fracture than those with no SE (odds ratio [OR] = 9.565; 95% confidence interval [CI] for OR = 1.054–86.799; P = 0.045), those with pneumohemothorax were about 5.7 times more likely to die from rib fracture than those with no pneumohemothorax (OR = 5.700; 95% CI for OR = 1.005–32.334; P = 0.049) and likelihood of death from rib fracture was found to be reduced in patients with unilateral chest affected compared with those with bilateral chest affected (OR = 0.088;95% CI for OR = 0.014–0.544; P = 0.009). Conclusion: SE, pneumohemothorax, and involvement of both hemithoraces were identified as predictors of survival following TRF, and thus, there should be the need expeditiously to manage the patients.