Risk factors associated with medium- to long-term outcome and health-related quality of life of patients with conservatively treated rib fractures

Patients with rib fractures often suffer from prolonged pain and dyspnea. The purpose of this study was to evaluate the mid- and long-term outcomes and major predisposing risk factors for clinical limitations such as pain or reduced lung capacity in patients with conservatively managed rib fractures to provide a basis for optimizing current therapy. Patients who underwent conservative management of rib fractures between 2014 and 2018 at a level I trauma center were retrospectively reviewed. Inclusion criteria were Injury Severity Score (ISS) ≤ 16 points and a minimum follow-up of 3 years. Outcome parameters were the SF-36 physical and mental component summary score (PCS and MCS, respectively) as well as current pain and respiratory problems. Risk factors evaluated included age, body mass index (BMI), in-hospital days, number of rib fractures, fracture dislocation and serial rib fracture. PCS was comparable to the normal population. The correlation between age and PCS was significant, p = .002. BMI correlated significantly with PCS, p < .001, current pain, p = .034 and respiratory problems, p = .029. No significant correlations were observed for the number of rib fractures and in-hospital days. Fracture dislocation and serial rib fracture showed no effect on PCS, p = .134 and p = .914, respectively, and current pain, p = .916 and p = .357, respectively. In the medium- to long-term, conservative treatment of simple rib fractures or serial rib fractures showed good results, but was negatively affected by a high patient age or BMI.