Quality of life outcomes after surgical intervention in patients with multiple rib fractures: A prospective cohort study

医学 简明伤害量表 损伤严重程度评分 生活质量(医疗保健) 前瞻性队列研究 重症监护室 队列 体质指数 外科 总体表面积 毒物控制 急诊医学 伤害预防 内科学 护理部
作者
Kuan-Hsun Lian,Chi-Cheng Yang,Fu‐Chang Hu,Wen‐Ying Lin,Wei-Ling Hsiao,Tzu-Hsin Lin,Rey‐Heng Hu,Jin‐Shing Chen,Hsien‐Chi Liao
出处
期刊:Surgery [Elsevier BV]
卷期号:173 (4): 1066-1071 被引量:1
标识
DOI:10.1016/j.surg.2022.12.006
摘要

Abstract

Background

Optimized conservative treatment of rib fractures has long been practiced, but surgical fixation has not been promising until recently. We aimed to examine and analyze immediate postoperative outcomes and 6-month quality of life after injury in patients with moderately severe traumatic rib fractures.

Methods

We conducted a prospective cohort study between July 2017 and June 2019 at the National Taiwan University Hospital. Seventy-two patients with moderately severe thoracic trauma were enrolled; 38 received conservative treatment and 34 underwent surgical fixation. Quality of life was measured using the 36-item Short Form Survey at; the first 3 days of hospitalization; before discharge; and at 1-, 2-, and 6-month follow-ups (visits 1–5). Baseline characteristics and clinical outcomes were recorded, and linear regression analysis was conducted using the generalized estimating equation.

Results

Among patients with moderately severe thoracic injury (chest Abbreviated Injury Scale score≥ 2), the operative group had more severe injuries and longer intensive care unit and in-hospital stays. However, they had a comparable quality of life 6 months after injury and higher physical component scores in the early postoperative period. Linear regression analysis obtained an equation with several factors positively affecting prediction of the mean physical component score, such as body mass index ≤25, age ≤36 years, fewer ribs requiring fixation, and diabetes mellitus. Mental component score did not show an upward trend, but the Work Quality Index largely determined the predicted mean value of the mental component score.

Conclusion

Surgical rib fixations hasten recovery in patients with severe thoracic injury (chest Abbreviated Injury Scale ≥3) to achieve 6-month quality of life comparable to patients injured less severely (chest Abbreviated Injury Scale ≥2). The ability to resume previous work positively influenced the mental component score; thus, surgical intervention should also aim to help patients regain their social function.
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