Evidence map›Paper›PMID 40875002›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Demographics, treatment, and outcomes of rib fractures in older adults: a retrospective multi-institutional study.

Emma V Cooper, Ian Hughes, Don Campbell, Adam Mahoney, Zsolt J Balogh, Silvana F Marasco, Bhavik Patel

Abstract readMulticenter StudyLetter
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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Effects of early surgery (within 48 hours)Journal of thoracic disease · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Emma V CooperBond University, Gold Coast University Hospital, 1, Hospital Boulevard, Queensland, Australia.ORCID http://orcid.org/0000-0001-5782-7699
Ian HughesBond University, Gold Coast University Hospital, 1, Hospital Boulevard, Queensland, Australia.
Don CampbellBond University, Gold Coast University Hospital, 1, Hospital Boulevard, Queensland, Australia.
Adam MahoneyRoyal Hobart Hospital, Hobart, TAS, Australia.
Zsolt J BaloghUniversity of Newcastle, John Hunter Hospital, New Lambton Heights, NSW, Australia.
Silvana F MarascoThe Alfred Hospital, Melbourne, Australia.
Bhavik PatelBond University, Gold Coast University Hospital, 1, Hospital Boulevard, Queensland, Australia. drbhavikpatel@hotmail.com.ORCID http://orcid.org/0000-0002-6179-0507

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRib fractures in the elderly can lead to significant morbidity and mortality. Management is generally conservative due to the perceived risks related to frailty and co-morbidities. The primary aim of this exploratory study was to describe the demographics and outcomes of traumatic rib fractures in older Australians admitted to major trauma centres. The secondary aim was to describe the management strategies employed, the involvement of specialist pain services, involvement of geriatric services, availability of surgical options and evaluate any variability in management at participating centres.

methodsMulticentre, retrospective cohort. Patients ≥ 70 years with multiple rib fractures admitted to Australian Level 1 trauma centres during 2019. Outcomes included: demographics and mechanisms of injury, treatment and management practices (ICU admission, mechanical ventilation, analgesia mode and pain service use, surgery, geriatrics involvement), and patients' clinical outcomes.

results491 patients were included from six centres. 282 (57.4%) were male, 445 (90.6%) from home, 218 (44.4%) fell from < 1 m, with a median 5.5 fractures, and Injury Severity Score (ISS) 13. Rates of low energy fall as mechanism of injury varied by site (range 16-62%, P = 0.001), the number of fractured ribs (P = 0.45) and ISS (P = 0.1) were consistent across sites. 208 (42.4%; range 19-55%, P < 0.001) were admitted to ICU with 53 (10.8%; range 7-29%, P = 0.002) ventilated. Acute Pain Services were utilised for 340 (69.4%; range 60-88%, P = 0.07) patients, 132 (27.0%; range 19-50%, P < 0.001) had regional anaesthesia and 167 (67%; range 4-79%. P < 0.001) geriatric input. Surgical rib fixation occurred in 14 (2.9%; range 0-9.2%). Median hospital LOS was 8.1 days (IQR 4.2, 13.4) with 234 (47.7%) returning home. In-hospital mortality was 42 (8.6%). 181 patients (36.9%; range 24-53%, P = 0.02) had at least one complication.

conclusionsThere is significant variability in the demographics of elderly patients presenting with rib fractures and discrepancy in management of these patients at Australia's Level 1 trauma centres. This study presents an opportunity to further investigate the presence of a causal relationship, optimise treatment strategies for best clinical outcomes and future prospective and interventional studies in this high-risk population.

Indexed as

Rib FracturesAccidental FallsAgedAged, 80 and overAustraliaFemaleHumansInjury Severity ScoreLength of StayMalePain ManagementRespiration, ArtificialRetrospective StudiesTrauma CentersTreatment OutcomeAcute pain servicesGeriatricsRib fracturesSurgical stabilisation of rib fracturesTrauma

Identifiers

PMID40875002

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.