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. 2021 Jan 1;90(1):73-78.
doi: 10.1097/TA.0000000000002917.

Prospective study of short-term quality-of-life after traumatic rib fractures

Jeff Choi  1 , Suleman Khan, Nicholas A Hakes, Garrison Carlos, Ryan Seltzer, Joshua D Jaramillo, David A Spain
Affiliations

Prospective study of short-term quality-of-life after traumatic rib fractures

Jeff Choi et al. J Trauma Acute Care Surg. .

Abstract

Background: Postdischarge convalescence after traumatic rib fractures remains unclear. We hypothesized that patients with rib fractures, even as an isolated injury, have associated poor quality of life (QoL) after discharge.

Methods: We prospectively enrolled adult patients at our level I trauma center with rib fractures between July 2019 and January 2020. We assessed QoL at 1 and 3 months after discharge using the Trauma-specific Quality-of-Life (T-QoL; 43-question survey evaluating five QoL domains on a 4-point Likert scale, where 4 indicates optimal and 1, worst QoL) and supplementary questionnaires. We used generalized estimating equations to assess T-QoL score trends over time and effect of age, sex, injury pattern, self-perceived injury severity, and Injury Severity Score.

Results: We enrolled 139 patients (108 completed the first and 93 completed both surveys). Three months after discharge, 33% of patients were not working at preinjury capacity, and 7% were still using opioid analgesia. Suffering rib fractures mostly impacted recovery and resilience (T-QoL score, mean [robust standard error] at 1 month, 2.7 [0.1]; 3 months, 3.0[0.1]) and physical well-being domains (1 month, 2.5 [0.1]; 3 months, 2.9[0.1]). Quality of life improved over time across all domains. Compared with patients who perceived their injuries as mild/moderate, patients who perceived their injuries as severe/very severe reported worse T-QoL scores across all domains. In contrast, Injury Severity Score did not affect QoL. Patients 65 years or older (-0.6 [0.1]) and women (-0.6 [0.2]) reported worse functional engagement compared with those 65 years or older and men, respectively.

Conclusion: We found that patients with traumatic rib fractures experience suboptimal QoL after discharge. Quality of life improved over time, but even 3 months after discharge, patients reported challenges performing activities of daily living, slower-than-expected recovery, and not returning to work at preinjury capacity. Perception of injury severity had a large effect on QoL. Patients with rib fractures may benefit from close short-term follow-up.

Level of evidence: Prognostic and epidemiological, level III.

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References

    1. Witt CE, Bulger EM. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma Surg Acute Care Open . 2017;2(1):e000064.
    1. Brasel K, Moore E, Albrecht R, et al. Western Trauma Association Critical Decisions in Trauma: management of rib fractures. J Trauma Acute Care Surg . 2017;82(1):200–203.
    1. Kasotakis G, Hasenboehler EA, Streib EW, Patel N, Patel MB, Alarcon L, Borsage PL, Love J, Haut ER, Como JJ. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg . 2017;82(3):618–626.
    1. Shelat VG, Eileen S, John L, Teo LT, Vijayan A, Chiu MT. Chronic pain and its impact on quality of life following a traumatic rib fracture. Eur J Trauma Emerg Surg . 2012;38(4):451–455.
    1. Fabricant L, Ham B, Mullins R, Mayberry J. Prolonged pain and disability are common after rib fractures. Am J Surg . 2013;205(5):511–515; discusssion 515–516.

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