Perceptions in rib injuries: A multidisciplinary single center survey of clinician differences in risk stratification and management of patients with rib fractures

Abstract

BackgroundAlthough associated with significant morbidity, there is no universally accepted management of rib fractures. We hypothesized that variations in risk stratification may influence this. MethodsA questionnaire was developed to assess providers’ perceived risk factors and injury stratification of rib fracture patients at a Level 1 trauma center. ResultsThere were 143 responses (36% physician response rate). Hypoxia, age, number of ribs fractured, pre-existing pulmonary disease, and flail chest were identified as the most important risk factors determining morbidity and mortality in blunt chest trauma. While clinicians agreed on predicted mortality for <2 fractured ribs, significant variation for 5–6 and >8 rib fractures was seen. EM and surgery providers significantly differed in assessment of injury severity. ConclusionProviders identified common risk factors for increased morbidity and mortality. However, the difference in perceived severity between providers indicates a need for clinical tools to assist in better standardizing rib fracture management.