Prospective Study of Short-Term Quality-of-Life After Traumatic Rib Fractures. The journal of trauma and acute care surgery Choi, J., Khan, S., Hakes, N. A., Carlos, G., Seltzer, R., Jaramillo, J. D., Spain, D. A. 2020


Post-discharge convalescence after traumatic rib fractures remains unclear. We hypothesized that patients with rib fractures, even as an isolated injury, have associated poor QoL after discharge.We prospectively enrolled adult patients at our Level I trauma center with rib fractures between July 2019 and January 2020. We assessed QoL at 1 and 3-months after discharge using the Trauma-specific Quality-of-Life (T-QoL: 43-question survey evaluating five QoL domains on a four-point Likert scale. "4" indicates optimal and "1" worst QoL) and supplementary questionnaires. We used generalized estimating equations to assess T-QoL score trends over time and effect of age, sex, injury pattern, self-perceived injury severity, and injury severity score.We enrolled 139 patients (108 completed the first and 93 completed both surveys). Three months after discharge, 33% of patients were not working at pre-injury capacity and 7% were still using opioid analgesia. Suffering rib fractures most impacted recovery and resilience (T-QoL score, mean [robust standard error] at 1-month: 2.7[0.1], 3-months: 3.0[0.1]) and physical well-being domains (1-month: 2.5[0.1]; 3-months 2.9[0.1]). QoL improved over time across all domains. Compared with patients who perceived their injuries as mild/moderate, patients who perceived their injuries as severe/very severe reported worse T-QoL scores across all domains. In contrast, injury severity score did not affect QoL. Patients aged =65 years (-0.6[0.1]) and females (-0.6[0.2]) reported worse functional engagement compared with those aged =65 years and males, respectively.We found that patients with traumatic rib fractures experience suboptimal QoL after discharge. QoL improved over time, but even three months after discharge, patients reported challenges performing activities of daily living, slower-than-expected recovery, and not returning to work at pre-injury capacity. Perception of injury severity had a large effect on QoL. Patients with rib fractures may benefit from close short-term follow-up.Prognostic and Epidemiological LEVEL OF EVIDENCE: Level III.

View details for DOI 10.1097/TA.0000000000002917

View details for PubMedID 32925583