Analysis of the Status, Treatment and Outcomes of Rib Fractures

A retrospective analysis of all patient presenting with multiple rib fractures to the emergency room of Penn State Hershey Medical Center between 2010-2012. Patient demographics, cause of fracture, outcomes, chronic medical conditions, vital signs, length of stay, pain levels and treatment, and sequelae will be recorded and analyzed.

Study Overview

• Status: Completed
• Conditions: Trauma; Rib Fracture

Detailed Description

This is a retrospective chart review with follow-up phone calls.

The initial part of the study will be a retrospective chart review. For this chart review study, the following data elements will be entered for each participant.

The investigators will perform a retrospective study of patients who have been treated for rib fractures at Penn State Hershey Medical Center (PSHMC). The time period of review will be 1/10/10 - 1/10/12 until 1500 cases have been reviewed. Data collected will be:

• Patient Medical Record Number (MRN)
• Name
• Phone number
• length of stay (admit and discharge date)
• Number of rib fractures per patient
• Cause of rib fracture
• Characteristics of the fracture (unilateral versus bilateral and multiple versus single)
• Pain management used for the rib fracture including pain interventions, medications and all pain scores

• Complications attributable to the rib fracture, including:

  1. Shortness of Breath (SOB)
  2. Hemothorax,
  3. Pneumothorax
  4. Flail chest
  5. Intubation required
  6. Mechanical ventilation required
  7. Opioids required for pain
  8. Chest tube placement required

• Sequelae of rib fracture, including:

  1. Acute Respiratory Deficiency Syndrome (ARDS)
  2. Pneumonia
  3. Death
  4. chronic pain
  5. delayed subclavian vessel thrombosis
  6. aortic aneurysm
  7. tracheobronchial fistula
  8. thoracic outlet syndrome
  9. Horner's syndrome

• Clinical history of

  1. Rib fractures
  2. Other fractures
  3. Osteoporosis
  4. Chronic Obstructive Pulmonary Disease (COPD)
  5. Cancer
  6. Myocardial Infarction (MI) / Coronary Artery Disease (CAD)
  7. Arthritis
  8. Parkinson's disease

• Patient characteristics:

  1. Age
  2. Gender
  3. Race
  4. Body Mass Index (BMI)
  5. Alcohol use
  6. Smoking status
  7. Marital status
  8. Education
  9. Initial blood pressure

7.2.2 Follow-up phone calls

The investigators will then attempt to call the patients for follow-up information using a summary explanation of research phone script to obtain the following information:

1. pain score
2. quality of life via the EuroQol's quality of life survey :EQ-5D-3L questionnaire
3. pain meds

• Study Type: Observational
• Enrollment (Actual): 921

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All patients presenting during 2010-2012 with multiple rib fractures to PSHMC emergency department

Description

Inclusion Criteria:

• must have above and be notated in our medical record

Exclusion Criteria:

• missing data

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Types and treatment of Rib Fractures	Characteristics of the fracture (unilateral versus bilateral and multiple versus single); Pain management used for the rib fracture including pain interventions, medications and all pain scores	Past 4 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
sequelae and complications from rib fractures	sequelae and complications in patients presenting with rib fractures: •Complications attributable to the rib fracture, including: Shortness of Breath (SOB); Hemothorax,; Pneumothorax; Flail chest; Intubation required; Mechanical ventilation required; Opioids required for pain; Chest tube placement required	Past 4 years
Pain levels		Past 4 years
Patient Characteristics	Clinical history ofRib fracturesOther fracturesOsteoporosisChronic Obstructive Pulmonary Disease (COPD)CancerMyocardial Infarction (MI) / Coronary Artery Disease (CAD)ArthritisParkinson's disease; Patient characteristics:AgeGenderRaceBody Mass Index (BMI)Alcohol useSmoking statusMarital statusEducationInitial blood pressure	past 4 years
Current patient quality of life as assessed by telephone survey	Follow-up phone calls The investigators will then attempt to call the patients for follow-up information using a summary explanation of research phone script to obtain the following information: pain score; quality of life via the EuroQol's quality of life survey :EQ-5D-3L questionnaire; pain meds	past 4 years

Collaborators and Investigators

• Sponsor: Milton S. Hershey Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2013
• Primary Completion (Actual): October 30, 2016
• Study Completion (Actual): December 14, 2017

Study Registration Dates

• First Submitted: April 5, 2015
• First Submitted That Met QC Criteria: June 26, 2015
• First Posted (Estimate): July 1, 2015

Study Record Updates

• Last Update Posted (Actual): June 20, 2018
• Last Update Submitted That Met QC Criteria: June 19, 2018
• Last Verified: June 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Thoracic Injuries; Fractures, Bone; Rib Fractures
• Other Study ID Numbers: 1125