eP61 Demographics and Outcomes of Rib Fractures in a NHS England Trust

Résumé fourni par la source

Abstract Rib fractures make up 15% of emergency department (ED) admissions and are the most common fracture following major trauma. They are also associated with underlying pulmonary contusions such as pneumothorax and haemothorax, with the most common complication being pneumonia. Yet, there is no standardised guideline for its management in a NHS England Trust. An audit was therefore done to analyse the demographics of, and also to assess the outcomes of patients treated for rib fractures. Three months’ worth of data was collected retrospectively from hospital medical records. Collection criteria included all patients who presented to ED with blunt chest trauma. STUMBL score was calculated individually using MDCalc. Of the data collected (n = 147), 76 were included in the analysis. 71 were excluded (age <18, no rib fracture, polytrauma). The largest proportion (30.2%) of patients had a STUMBL score of 16-20. Mean age at presentation was 73.5. 76.3% had multiple rib fractures and 92% of these were unilateral. Over a third (35%) were on anticoagulants. 38.2% of patients were discharged home directly by ED. 12% of admissions developed pneumonia as a complication with 100% of them having a STUMBL score >11. 7.1% were readmitted within 30 days of discharge. Patients who presented with rib fractures had suboptimal outcomes. This has necessitated the development of a trust-wide, easily accessible guideline for its management. This guideline is currently mid-development with the input of a multidisciplinary team including ED, anaesthetics, frailty and general surgery. Another audit will be done after its implementation.

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