Evaluation of patients with surgically stabilized rib fractures by different scoring systems.

PURPOSE: Surgical Stabilization (SSRF) is gaining popularity as an alternative to non-operative management (NOM) of patients with rib fractures, however, there are no established guidelines for patients' quantifiable evaluation and for SSRF recommendation. Known rib scoring systems include: Rib Fracture Score (RFS), Chest Wall Trauma Score (CWTS), Chest Trauma Score (CTS) and RibScore (RS), but are underutilized. The purpose was to provide values of scoring systems in SSRF and NOM patients and correlate them with treatment assignment.

METHODS

Retrospective cohort study included 87 SSRF and 87 propensity matched NOM patients from two level-1 trauma centers. Clinical variables and score values were compared between two groups.

RESULTS

SSRF compared to NOM patients had significantly higher number of total rib fractures, displaced fractures, rates of pulmonary contusion and flail chest. RS and CTS values were significantly higher in SSRF compared to NOM patients (2.3 vs. 1.7, p = 0.001; 5.8 vs. 5.3, p = 0.005, respectively), but RFS and CWTS were similar.

CONCLUSIONS

Application of scoring systems could help with patients' objective and standardized assessment and may aid in treatment decisions. RibScore was superior to other scoring systems.