National Changes in Timing and Rates of Surgical Stabilization of Rib Fractures (SSRF): SSRF Occurring Early and More Often.

Surgical stabilization of rib fractures (SSRF) has garnered increased attention recently for treatment of blunt chest trauma (BCT). This study evaluated temporal trends in rates and timing of SSRF in isolated BCT patients, hypothesizing increased rates of early SSRF and SSRF overall. The 2017-2023 Trauma Quality Improvement Program (TQIP) database was queried for patients with ≥2 rib fractures and abbreviated injury scale <2 in non-chest regions to delineate an isolated BCT cohort. Patients were stratified by timing of SSRF from arrival: early (≤72 h), intermediate (>72-≤ 120 h), and late (>120 h). The primary outcome was annual rate of SSRF. Of 371,193 isolated BCT patients, 17 966 (4.8%) underwent SSRF from 2017 to 2023. The median age of patients undergoing SSRF increased from 58 years in 2017 to 61 years in 2023 (P < 0.001). There was an increased rate of SSRF performed from 2017 to 2023 (n = 1,594, 3.5% vs n = 3,435, 5.5%, P < 0.001). When stratified by timing, early (1.8% [2017]; 3.4% [2023], P < 0.001) and intermediate SSRF (0.9% [2017]; 1.3% [2023], P < 0.001) increased over time, whereas late SSRF remained similar across 2017 to 2023 (late: 0.8%; 0.8%, P = 0.25). For all SSRF patients, median overall length of stay (LOS) decreased over time (12 [IQR: 8-17] days [2017]; 11 [IQR: 8-16] days [2023]; P < 0.001). This study demonstrates a nearly 60% relative national increase in SSRF from 2017 to 2023, with a progressively older patient cohort and shorter LOS. This was predominantly attributable to increased early (≤72 h) and intermediate (>72-≤120 h) SSRF cases, aligning with existing guidelines.