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Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures
BACKGROUND: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. MATERIALS AND METHODS: Four hundred and eighteen patients who visited our hospital with multiple rib fractures betw...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society for Thoracic and Cardiovascular Surgery
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3631787/ https://www.ncbi.nlm.nih.gov/pubmed/23614099 http://dx.doi.org/10.5090/kjtcs.2013.46.2.130 |
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author | Byun, Joung Hun Kim, Han Young |
author_facet | Byun, Joung Hun Kim, Han Young |
author_sort | Byun, Joung Hun |
collection | PubMed |
description | BACKGROUND: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. MATERIALS AND METHODS: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. RESULTS: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). CONCLUSION: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly. |
format | Online Article Text |
id | pubmed-3631787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Korean Society for Thoracic and Cardiovascular Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-36317872013-04-23 Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures Byun, Joung Hun Kim, Han Young Korean J Thorac Cardiovasc Surg Clinical Research BACKGROUND: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. MATERIALS AND METHODS: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. RESULTS: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). CONCLUSION: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly. Korean Society for Thoracic and Cardiovascular Surgery 2013-04 2013-04-09 /pmc/articles/PMC3631787/ /pubmed/23614099 http://dx.doi.org/10.5090/kjtcs.2013.46.2.130 Text en © The Korean Society for Thoracic and Cardiovascular Surgery. 2013. All right reserved. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Byun, Joung Hun Kim, Han Young Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title | Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title_full | Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title_fullStr | Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title_full_unstemmed | Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title_short | Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures |
title_sort | factors affecting pneumonia occurring to patients with multiple rib fractures |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3631787/ https://www.ncbi.nlm.nih.gov/pubmed/23614099 http://dx.doi.org/10.5090/kjtcs.2013.46.2.130 |
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