Abstract
BackgroundRib fractures are associated with considerable morbidity and mortality. Surgical stabilization of rib fractures (SSRF) can be performed to mitigate complications. Sarcopenia is in general known to be associated with poor clinical outcomes. We investigated if sarcopenia impacted number of days of mechanical ventilation, intensive care unit (ICU) stay, and total hospital stay in patients who underwent SSRF.MethodsA retrospective single institutional review was performed including patients who underwent SSRF (2009–2017). Skeletal muscle index (SMI) was semiautomatically calculated at the L3 spinal level on computed tomography (CT) images and normalized by patient height. Sarcopenia was defined as SMI < 55 cm2/m2 in males and < 39 cm2/m2 in females. Demographics, operative details, and postoperative outcomes were reviewed. Univariate and multivariate analyses were performed.ResultsOf 238 patients, 88 (36.9%) had sarcopenia. There was no significant difference in number of days of mechanical ventilation (2.8 ± 4.9 versus 3.1 ± 4.3, p = 0.304), ICU stay (5.9 ± 6.5 versus 4.9 ± 5.7 days, p = 0.146), or total hospital stay (13.3 ± 7.2 versus 12.9 ± 8.2 days, p = 0.183) between sarcopenic and nonsarcopenic patients. Sarcopenic patients demonstrated increased modified frailty index scores (1.5 ± 1.1 versus 0.9 ± 0.9, p < 0.001) compared to nonsarcopenic patients.ConclusionsFor patients who underwent SSRF for rib fractures, sarcopenia did not increase the number of days of mechanical ventilation, ICU stay, or total hospital stay. Sarcopenia should not preclude the utilization of SSRF in these patients.
Highlights
Rib fractures are associated with considerable morbidity and mortality
In an effort to reduce morbidity and mortality associated with traumatic rib fractures, several investigators have shown benefits of surgical stabilization of rib fractures (SSRF), which include reductions in mechanical ventilation duration, mortality rates, development of pneumonia, pain, and long-term disability [4,5,6,7,8]
Patient cohort Institutional review board approval was obtained for this study, which was in compliance with the Health Insurance Portability and Accountability Act
Summary
Rib fractures are associated with considerable morbidity and mortality. Surgical stabilization of rib fractures (SSRF) can be performed to mitigate complications. Mortality after rib fractures is approximately 10% and increasing numbers of fractured ribs is associated with greater mortality and morbidity. In an effort to reduce morbidity and mortality associated with traumatic rib fractures, several investigators have shown benefits of surgical stabilization of rib fractures (SSRF), which include reductions in mechanical ventilation duration, mortality rates, development of pneumonia, pain, and long-term disability [4,5,6,7,8]. In patients with traumatic injuries, sarcopenia has been associated with increased mortality rates, duration of hospital stay, risk of complications, and more frequent patient discharges to a dependent facility [22, 23]
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