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

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*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

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.

Original languageEnglish
Pages (from-to)1066-1071
Number of pages6
JournalSurgery (United States)
Volume173
Issue number4
DOIs
StatePublished - 04 2023
Externally publishedYes

Bibliographical note

Copyright © 2022 Elsevier Inc. All rights reserved.

Keywords

  • Humans
  • Adult
  • Rib Fractures/surgery
  • Prospective Studies
  • Quality of Life
  • Thoracic Injuries/surgery
  • Hospitalization
  • Length of Stay
  • Retrospective Studies

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