2008 Annual Meeting Abstracts

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Pediatric rib fractures may not be a marker for worse outcomes
Amanda Feigel, MD, Felix Y. Lui, MD, Kevin M. Schuster, MD, Kimberly A. Davis, MD.
Yale Univ School of Medicine, New Haven, CT, USA.

Objective: Rib fractures in pediatric trauma patients are uncommon. Due to the flexibility of the ribs in children, when rib fractures do occur, they are believed to be markers of higher relative kinetic force. We hypothesize that rib fractures in the pediatric blunt trauma population are more significant markers of injury severity, morbidity and mortality than in the adult population.
Design: Retrospective trauma registry database review
Setting: Level I Adult and Pediatric university trauma center
Patients: All adult and pediatric blunt injury trauma patients evaluated for blunt trauma over a 5 year period
Interventions: None
Main outcome measures: Patient demographics and outcomes were retrospectively reviewed.
Results: A total of 8071 patients with blunt injury were evaluated, 6566 adults (75%) and 1515 pediatric (25%). The overall complication rate in adults with rib fractures was significantly higher than in pediatric patients. Pulmonary related complication rates were not significantly different between the two groups; 5.9% of adult patients with rib fractures and 2.6% of pediatric patients with rib fractures.

	Adults	Pediatrics	p
Number of patients	6556	1515
Overall mortality	5.2%	1.1%	<0.0001
Overall ISS	11.3 ± 10.3	8.6 ± 7.3	<0.0001
Rib fx mortality	11.3%	2.5%	<0.0001
Rib fx ISS	20.1 ± 15.0	16.9 ± 11.5	<0.0001
Overall complications
Rib fx complications	49.5%	15.4%	<0.0001

Conclusions: Pediatric patients with rib fractures tend to have fewer mortalities, less severe injuries, and fewer complications than adults with rib fractures. The presence of rib fractures in pediatric patients with blunt trauma may not be a marker for worse outcomes.

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