Analysis of the Status, Treatment and Outcomes of Rib Fractures
Condition: Rib Fracture; Trauma
MeSH terms: Fractures, Bone; Rib Fractures
Study type: Observational

Summary: 
      A retrospective analysis of all patient presenting with multiple rib fractures to the
      emergency room of Penn State Hershey Medical Center between 2010-2012. Patient demographics,
      cause of fracture, outcomes, chronic medical conditions, vital signs, length of stay, pain
      levels and treatment, and sequelae will be recorded and analyzed.
    

Detailed description: 
      This is a retrospective chart review with follow-up phone calls.

      The initial part of the study will be a retrospective chart review. For this chart review
      study, the following data elements will be entered for each participant.

      The investigators will perform a retrospective study of patients who have been treated for
      rib fractures at Penn State Hershey Medical Center (PSHMC). The time period of review will be
      1/10/10 - 1/10/12 until 1500 cases have been reviewed. Data collected will be:

        -  Patient Medical Record Number (MRN)

        -  Name

        -  Phone number

        -  length of stay (admit and discharge date)

        -  Number of rib fractures per patient

        -  Cause of rib fracture

        -  Characteristics of the fracture (unilateral versus bilateral and multiple versus single)

        -  Pain management used for the rib fracture including pain interventions, medications and
           all pain scores

        -  Complications attributable to the rib fracture, including:

             1. Shortness of Breath (SOB)

             2. Hemothorax,

             3. Pneumothorax

             4. Flail chest

             5. Intubation required

             6. Mechanical ventilation required

             7. Opioids required for pain

             8. Chest tube placement required

        -  Sequelae of rib fracture, including:

             1. Acute Respiratory Deficiency Syndrome (ARDS)

             2. Pneumonia

             3. Death

             4. chronic pain

             5. delayed subclavian vessel thrombosis

             6. aortic aneurysm

             7. tracheobronchial fistula

             8. thoracic outlet syndrome

             9. Horner's syndrome

        -  Clinical history of

             1. Rib fractures

             2. Other fractures

             3. Osteoporosis

             4. Chronic Obstructive Pulmonary Disease (COPD)

             5. Cancer

             6. Myocardial Infarction (MI) / Coronary Artery Disease (CAD)

             7. Arthritis

             8. Parkinson's disease

        -  Patient characteristics:

             1. Age

             2. Gender

             3. Race

             4. Body Mass Index (BMI)

             5. Alcohol use

             6. Smoking status

             7. Marital status

             8. Education

             9. Initial blood pressure

      7.2.2 Follow-up phone calls

      The investigators will then attempt to call the patients for follow-up information using a
      summary explanation of research phone script to obtain the following information:

        1. pain score

        2. quality of life via the EuroQol's quality of life survey :EQ-5D-3L questionnaire

        3. pain meds
    

Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All patients presenting during 2010-2012 with multiple rib fractures to PSHMC emergency
        department