Long-term morbidity, pain, and disability after repair of severe chest wall injuries

John C. Mayberry, Andrew D. Kroeker, Lyle (Bruce) Ham, Richard Mullins, Donald Trunkey

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70 Citations (Scopus)

Abstract

Long-term morbidity after severe chest wall injuries is common. We report our experience with acute chest wall injury repair, focusing on long-term outcomes and comparing our patients' health status with the general population. We performed a retrospective medical record review supplemented with a postal survey of long-term outcomes including the McGill Pain Questionnaire (MPQ) and RAND-36 Health Survey. RAND-36 outcomes were compared with reference values from the Medical Outcomes Study and from the general population. Forty-six patients underwent acute chest wall repair between September 1996 and September 2005. Indications included flail chest with failure to wean from the ventilator (18 patients), acute, intractable pain associated with severely displaced rib fractures (15 patients), acute chest wall defect/deformity (5 patients), acute pulmonary herniation (3 patients), and thoracotomy for other traumatic indications (5 patients). Three patients had a concomitant sternal fracture repair. Fifteen patients with a current mean age of 60.6 years (range 30-91) responded to our surveys a mean of 48.5 ± 22.3 months (range 19-96) postinjury. Mean long-term MPQ Pain Rating Index was 6.7 ± 2.1. RAND-36 indices indicated equivalent or better health status compared with references with the exception of role limitations due to physical problems when compared with the general population. The operative repair of severe chest wall injuries is associated with low long-term morbidity and pain, as well as health status nearly equivalent to the general population. Both the MPQ and the RAND-36 surveys were useful tools for determining chest wall pain and disability outcomes.

Original languageEnglish (US)
Pages (from-to)389-394
Number of pages6
JournalAmerican Surgeon
Volume75
Issue number5
StatePublished - May 2009

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Thoracic Injuries
Thoracic Wall
Morbidity
Pain
Pain Measurement
Health Status
Population
Flail Chest
Rib Fractures
Intractable Pain
Acute Pain
Thoracotomy
Mechanical Ventilators
Health Surveys
Chest Pain
Medical Records
Reference Values
Outcome Assessment (Health Care)
Lung

ASJC Scopus subject areas

  • Surgery

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Long-term morbidity, pain, and disability after repair of severe chest wall injuries. / Mayberry, John C.; Kroeker, Andrew D.; Ham, Lyle (Bruce); Mullins, Richard; Trunkey, Donald.

In: American Surgeon, Vol. 75, No. 5, 05.2009, p. 389-394.

Research output: Contribution to journalArticle

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