Factors Affecting Length of Stay in Patients With Traumatic Rib Fractures in a District General Hospital.

Abstract

Abstract Objective The objective of this study was to ascertain which patient factors, injury and treatment variables contributed to an increased length of stay (LOS). Methods Retrospective data collection from a prospectively updated dataset was conducted from 01.01.23 to 31.08.23. All adult patients admitted to the general surgical department were included. Transfers directly from ED to an MTC, and paediatric patients were excluded. Outcome parameters were: age, gender, clinical frailty score (CFS), preinjury antiplatelet/anticoagulant use, mechanism of injury, number of ribs fractured, battle score, presence of intrathoracic injury, presence of flail chest, chest drain insertion, performance of analgesic nerve block, discussion with local MTC, total LOS, and 30-day mortality. Statistical analysis was performed to ascertain which of these variables significantly affected patient LOS. Results 92 patients were admitted to the DGH. Most were female (58.7%) and the median age was 73. Median LOS was 5.5 days. 7 patients died during admission, all with a CFS of 6 or over. Patients with a higher age, CFS, number of fractures, and battle score had a significantly longer LOS. Patients who underwent a nerve block also had a longer LOS than those who did not. Presence of intra-thoracic injury and placement of a surgical chest drain did not affect LOS. Conclusions LOS appears to be related to higher age, frailty, and battle score. To improve patient management at this DGH, it may be suggested that older patients with a high battle score be discussed with critical care and have early frailty team input.