Rib fracture pain and disability

Can we do better?

Mahlon A. Kerr-Valentic, Melanie Arthur, Richard Mullins, Tuesday E. Pearson, John C. Mayberry, Barry A. Hicks, Gil Cryer, Erik Barquist

    Research output: Contribution to journalArticle

    103 Citations (Scopus)

    Abstract

    Objective: The purpose of this study was to determine the magnitude and duration of pain and disability in patients with rib fractures treated using current standard therapy. This was a prospective case series. Methods: Injured patients with a chest radiographic diagnosis of one or more rib fractures between June 1, 2001, and October 31, 2001, were asked to participate. Pain levels were assessed at days 1, 5, 30, and 120 after injury using a visual pain scale (0-10). Disability at 30 days was assessed using the SF-36 Health Status Survey, and the total number of days lost from work/usual activity was recorded at day 120. The setting was a university-based Level I trauma center. Results: Forty patients with a mean of 2.7 ± 1.6 rib fractures were enrolled. Twenty-three patients had isolated rib fractures and 17 patients had associated extrathoracic injuries. Mean rib fracture pain was 3.5 ± 2.1 at 30 days and 1.0 ± 1.4 at 120 days. For patients with associated extrathoracic injuries, rib pain was equivalent to pain in the rest of the body at all intervals. When compared with the chronically ill reference population of the RAND Medical Outcomes Study, our patients as a group were more disabled at 30 days (p <0.001) in all categories except emotional stability, where they showed equivalent disability, and in their perception of general health, where they were significantly less disabled (p <0.001). The total mean days lost from work/usual activity was 70 ± 41. Patients with isolated rib fractures went back to work/usual activity at a mean of 51 ± 39 days compared with 91 ± 33 days in patients with associated extrathoracic injuries (p <0.01). Conclusion: Rib fractures are a significant cause of pain and disability in patients with isolated thoracic injury and in patients with associated extrathoracic injuries. Developing new therapies to accelerate pain relief and healing would substantially improve the outcome of patients with rib fractures.

    Original languageEnglish (US)
    Pages (from-to)1058-1064
    Number of pages7
    JournalJournal of Trauma - Injury, Infection and Critical Care
    Volume54
    Issue number6
    StatePublished - Jun 1 2003

    Fingerprint

    Rib Fractures
    Pain
    Wounds and Injuries
    Thoracic Injuries
    Return to Work
    Trauma Centers
    Ribs
    Health Surveys
    Health Status

    Keywords

    • Disability.
    • Pain
    • Rib fracture
    • Thoracic
    • Trauma

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Kerr-Valentic, M. A., Arthur, M., Mullins, R., Pearson, T. E., Mayberry, J. C., Hicks, B. A., ... Barquist, E. (2003). Rib fracture pain and disability: Can we do better? Journal of Trauma - Injury, Infection and Critical Care, 54(6), 1058-1064.

    Rib fracture pain and disability : Can we do better? / Kerr-Valentic, Mahlon A.; Arthur, Melanie; Mullins, Richard; Pearson, Tuesday E.; Mayberry, John C.; Hicks, Barry A.; Cryer, Gil; Barquist, Erik.

    In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 54, No. 6, 01.06.2003, p. 1058-1064.

    Research output: Contribution to journalArticle

    Kerr-Valentic, MA, Arthur, M, Mullins, R, Pearson, TE, Mayberry, JC, Hicks, BA, Cryer, G & Barquist, E 2003, 'Rib fracture pain and disability: Can we do better?', Journal of Trauma - Injury, Infection and Critical Care, vol. 54, no. 6, pp. 1058-1064.
    Kerr-Valentic MA, Arthur M, Mullins R, Pearson TE, Mayberry JC, Hicks BA et al. Rib fracture pain and disability: Can we do better? Journal of Trauma - Injury, Infection and Critical Care. 2003 Jun 1;54(6):1058-1064.
    Kerr-Valentic, Mahlon A. ; Arthur, Melanie ; Mullins, Richard ; Pearson, Tuesday E. ; Mayberry, John C. ; Hicks, Barry A. ; Cryer, Gil ; Barquist, Erik. / Rib fracture pain and disability : Can we do better?. In: Journal of Trauma - Injury, Infection and Critical Care. 2003 ; Vol. 54, No. 6. pp. 1058-1064.
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    abstract = "Objective: The purpose of this study was to determine the magnitude and duration of pain and disability in patients with rib fractures treated using current standard therapy. This was a prospective case series. Methods: Injured patients with a chest radiographic diagnosis of one or more rib fractures between June 1, 2001, and October 31, 2001, were asked to participate. Pain levels were assessed at days 1, 5, 30, and 120 after injury using a visual pain scale (0-10). Disability at 30 days was assessed using the SF-36 Health Status Survey, and the total number of days lost from work/usual activity was recorded at day 120. The setting was a university-based Level I trauma center. Results: Forty patients with a mean of 2.7 ± 1.6 rib fractures were enrolled. Twenty-three patients had isolated rib fractures and 17 patients had associated extrathoracic injuries. Mean rib fracture pain was 3.5 ± 2.1 at 30 days and 1.0 ± 1.4 at 120 days. For patients with associated extrathoracic injuries, rib pain was equivalent to pain in the rest of the body at all intervals. When compared with the chronically ill reference population of the RAND Medical Outcomes Study, our patients as a group were more disabled at 30 days (p <0.001) in all categories except emotional stability, where they showed equivalent disability, and in their perception of general health, where they were significantly less disabled (p <0.001). The total mean days lost from work/usual activity was 70 ± 41. Patients with isolated rib fractures went back to work/usual activity at a mean of 51 ± 39 days compared with 91 ± 33 days in patients with associated extrathoracic injuries (p <0.01). Conclusion: Rib fractures are a significant cause of pain and disability in patients with isolated thoracic injury and in patients with associated extrathoracic injuries. Developing new therapies to accelerate pain relief and healing would substantially improve the outcome of patients with rib fractures.",
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