Perceptions in rib injuries: A multidisciplinary single center survey of clinician differences in risk stratification and management of patients with rib fractures - 14/06/19
, Claire P. Miller a , Allan E. Stolarski b , Ashar Ata a , Ashley Bartscherer a , Sean P. Geary c , Carl Rosati a , Joseph DuBose d , Marcel Tafen a, ⁎ , Steven C. Stain a Abstract |
Background |
Although associated with significant morbidity, there is no universally accepted management of rib fractures. We hypothesized that variations in risk stratification may influence this.
Methods |
A questionnaire was developed to assess providers’ perceived risk factors and injury stratification of rib fracture patients at a Level 1 trauma center.
Results |
There were 143 responses (36% physician response rate). Hypoxia, age, number of ribs fractured, pre-existing pulmonary disease, and flail chest were identified as the most important risk factors determining morbidity and mortality in blunt chest trauma. While clinicians agreed on predicted mortality for <2 fractured ribs, significant variation for 5–6 and >8 rib fractures was seen. EM and surgery providers significantly differed in assessment of injury severity.
Conclusion |
Providers identified common risk factors for increased morbidity and mortality. However, the difference in perceived severity between providers indicates a need for clinical tools to assist in better standardizing rib fracture management.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Clinicians agreed on factors associated with increased rib fracture complications. |
• | Emergency physicians had higher perceptions of injury severity compared to surgeons. |
• | High discordance exists between clinicians when estimating rib fracture mortality. |
Résumé |
A range of providers identified common risk factors for increased morbidity and mortality in patients with rib fractures. However, significant variation in perceived severity was seen across all providers with increased number of rib fractures and between emergency medicine and surgery when assessing clinical vignettes.
Le texte complet de cet article est disponible en PDF.Keywords : Rib fractures, Morbidity, Mortality
Plan
Vol 218 - N° 1
P. 32-36 - juillet 2019 Retour au numéro
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