Vital capacity helps predict pulmonary complications after rib fractures

Thomas W. Carver, David J. Milia, Chloe Somberg, Karen Brasel, Jasmeet Paul

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. METHODS This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ2 and multivariate logistic regression. RESULTS Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72%) were discharged home, and 26% went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10% increase in VC was associated with 36% decrease in likelihood of pulmonary complication. Patients with a VC greater than 50% had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30% was independently associated with pulmonary complication (odds ratio, 2.36). CONCLUSION Patients with fractured ribs and VC of less than 30% have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help identify those at risk for complications after rib fractures, but a prospective study is necessary to confirm these findings.

Original languageEnglish (US)
Pages (from-to)413-416
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Volume79
Issue number3
DOIs
StatePublished - Sep 5 2015
Externally publishedYes

Fingerprint

Rib Fractures
Vital Capacity
Lung
Skilled Nursing Facilities
Injury Severity Score
Ribs
Intensive Care Units
Length of Stay
Abbreviated Injury Scale
Hemothorax
Chest Tubes
Thoracic Injuries
Contusions
Trauma Centers
Pneumothorax
Intubation
Chronic Obstructive Pulmonary Disease
Pneumonia

Keywords

  • chest trauma
  • rib fractures
  • Vital capacity

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery
  • Medicine(all)

Cite this

Vital capacity helps predict pulmonary complications after rib fractures. / Carver, Thomas W.; Milia, David J.; Somberg, Chloe; Brasel, Karen; Paul, Jasmeet.

In: Journal of Trauma and Acute Care Surgery, Vol. 79, No. 3, 05.09.2015, p. 413-416.

Research output: Contribution to journalArticle

Carver, Thomas W. ; Milia, David J. ; Somberg, Chloe ; Brasel, Karen ; Paul, Jasmeet. / Vital capacity helps predict pulmonary complications after rib fractures. In: Journal of Trauma and Acute Care Surgery. 2015 ; Vol. 79, No. 3. pp. 413-416.
@article{377c99b7b8014d7091571480cdf3388d,
title = "Vital capacity helps predict pulmonary complications after rib fractures",
abstract = "BACKGROUND Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. METHODS This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ2 and multivariate logistic regression. RESULTS Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72{\%}) were discharged home, and 26{\%} went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10{\%} increase in VC was associated with 36{\%} decrease in likelihood of pulmonary complication. Patients with a VC greater than 50{\%} had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30{\%} was independently associated with pulmonary complication (odds ratio, 2.36). CONCLUSION Patients with fractured ribs and VC of less than 30{\%} have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help identify those at risk for complications after rib fractures, but a prospective study is necessary to confirm these findings.",
keywords = "chest trauma, rib fractures, Vital capacity",
author = "Carver, {Thomas W.} and Milia, {David J.} and Chloe Somberg and Karen Brasel and Jasmeet Paul",
year = "2015",
month = "9",
day = "5",
doi = "10.1097/TA.0000000000000744",
language = "English (US)",
volume = "79",
pages = "413--416",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Vital capacity helps predict pulmonary complications after rib fractures

AU - Carver, Thomas W.

AU - Milia, David J.

AU - Somberg, Chloe

AU - Brasel, Karen

AU - Paul, Jasmeet

PY - 2015/9/5

Y1 - 2015/9/5

N2 - BACKGROUND Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. METHODS This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ2 and multivariate logistic regression. RESULTS Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72%) were discharged home, and 26% went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10% increase in VC was associated with 36% decrease in likelihood of pulmonary complication. Patients with a VC greater than 50% had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30% was independently associated with pulmonary complication (odds ratio, 2.36). CONCLUSION Patients with fractured ribs and VC of less than 30% have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help identify those at risk for complications after rib fractures, but a prospective study is necessary to confirm these findings.

AB - BACKGROUND Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. METHODS This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ2 and multivariate logistic regression. RESULTS Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72%) were discharged home, and 26% went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10% increase in VC was associated with 36% decrease in likelihood of pulmonary complication. Patients with a VC greater than 50% had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30% was independently associated with pulmonary complication (odds ratio, 2.36). CONCLUSION Patients with fractured ribs and VC of less than 30% have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help identify those at risk for complications after rib fractures, but a prospective study is necessary to confirm these findings.

KW - chest trauma

KW - rib fractures

KW - Vital capacity

UR - http://www.scopus.com/inward/record.url?scp=84940872274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940872274&partnerID=8YFLogxK

U2 - 10.1097/TA.0000000000000744

DO - 10.1097/TA.0000000000000744

M3 - Article

VL - 79

SP - 413

EP - 416

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 3

ER -