Variation in Adherence to Guideline Recommendations for Management of Rib Fractures

Although few patients with rib fractures received guideline-recommended care at U.S. trauma centers, this may be more indicative of variation in patient presentation than a gap in quality care.

Rib fractures are associated with significant morbidity and mortality, particularly in older patients. Professional society guidelines recommend the following for adults ≥65 years old with three or more rib fractures: (1) epidural or paravertebral analgesia; (2) intensive care unit (ICU) admission; (3) pneumatic stabilization with noninvasive ventilation; (4) chest computed tomography (CT); (5) surgical fixation of flail chest; (6) tube thoracostomy for hemothorax, pneumothorax, or both (the latter two practices are recommended for patients of any age).

Researchers analyzed data from the National Trauma Data Bank for 625,617 patients ≥16 years old with at least one rib fracture from 2007 to 2014. Only 4% of qualifying patients received epidu…

Reviewing Author

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Variation in Adherence to Guideline Recommendations for Management of Rib Fractures

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Reviewing Author