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Older Adults With Isolated Rib Fractures Do Not Require Routine Intensive Care Unit Admission

Authors :
Daniel K. Nishijima
Garth H. Utter
Jessica A. Bowman
Gregory J. Jurkovich
Source :
J Surg Res
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

BackgroundOlder adults with isolated rib fractures are often admitted to an intensive care unit (ICU) because of presumedly increased morbidity and mortality. However, evidence-based guidelines are limited. We sought to identify characteristics of these patients that predict the need for ICU care.Materials and methodsWe analyzed patients ≥50y old at our center during 2013-2017 whose only indication for ICU admission, if any, was isolated rib fractures. The primary outcome was any critical care intervention (e.g., intubation) or adverse event (e.g., hypoxemia) (CCIE) based on accepted critical care guidelines. We used stepwise logistic regression to identify characteristics that predict CCIEs.ResultsAmong 401 patients, 251 (63%) were admitted to an ICU. Eighty-three patients (33%) admitted to an ICU and 7 (5%) admitted to the ward experienced a CCIE. The most common CCIEs were hypotension (10%), frequent respiratory therapy (9%), and oxygen desaturation (8%). Predictors of CCIEs included incentive spirometry

Details

ISSN :
00224804
Volume :
245
Database :
OpenAIRE
Journal :
Journal of Surgical Research
Accession number :
edsair.doi.dedup.....0da0207b528e71d690e0ca0bcf8f8d45
Full Text :
https://doi.org/10.1016/j.jss.2019.07.098