Journal of Chest Surgery

  • 제46권2호
  • /
  • Pages.130-134
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  • 2013
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures

  • Byun, Joung Hun (Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Han Young (Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2012.05.25
  • 심사 : 2012.08.24
  • 발행 : 2013.04.05
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초록

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.

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참고문헌

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피인용 문헌

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  2. Chest Trauma: An Overview vol.3, pp.1, 2015, https://doi.org/10.15406/jaccoa.2015.03.00082
  3. Comparative evaluation of continuous intercostal nerve block or epidural analgesia on the rate of respiratory complications, intensive care unit, and hospital stay following traumatic rib fractures: a vol.8, pp.None, 2015, https://doi.org/10.2147/lra.s80498
  4. Risk of pneumonia in patients with isolated minor rib fractures: a nationwide cohort study vol.7, pp.1, 2013, https://doi.org/10.1136/bmjopen-2016-013029
  5. Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures vol.50, pp.5, 2013, https://doi.org/10.5090/kjtcs.2017.50.5.346
  6. Factors affecting mortality in trauma patients with more than three rib fractures vol.53, pp.5, 2013, https://doi.org/10.4103/fjs.fjs_24_20
  7. Risk factors for ventilator-associated pneumonia in trauma patients with torso injury: a retrospective single-center study vol.49, pp.12, 2021, https://doi.org/10.1177/03000605211061029