Abstract | Cilj istraživanja: Cilj ovog istraživanja je usporediti epidemiološke, demografske i kliničke karakteristike, ishode liječenja te utvrditi potrebu za hospitalizacijom u bolesnika liječenih zbog prijeloma rebara.
Ispitanici i metode: Ispitanici su svi bolesnici liječeni zbog prijeloma rebara u Odjelu za torakalnu kirurgiju u razdoblju od 1. siječnja 2019. do 31. prosinca 2019. Za potrebe ovog istraživanja bolesnicima su analizirani sljedeći parametri: dob, spol, broj slomljenih rebara, komplikacije pri prijemu, komplikacije tijekom liječenja, način liječenja i duljina hospitalizacije.
Rezultati: U 2019. godini u Odjelu za torakalnu kirurgiju KBC-a Split liječeno je 174 bolesnika hospitaliziranih zbog prijeloma rebara (36,2% žena i 63,8% muškaraca). Najveći broj bolesnika je imao serijski prijelom rebara (n=121; 69,5%). Raspodjela bolesnika s obzirom na komplikacije pri prijemu pokazala je da većina bolesnika (70,7%) prilikom prijema nije imala razvijene komplikacije (p<0,001). Srednja vrijednost dobi bila je za šest godina veća kod bolesnika koji nisu imali komplikacije pri prijemu u odnosu na bolesnike koji su imali komplikacije pri prijemu (p=0,054). Medijan duljine hospitalizacije iznosio je pet (IQR 4, 6) dana, dok je medijan duljine hospitalizacije bio za dva dana dulji u bolesnika s komplikacijama u odnosu na bolesnike bez komplikacija (p<0,001). Najveći broj bolesnika koji nisu imali komplikacije pri prijemu nisu razvili komplikacije do kraja liječenja (p<0,001). Najčešća komplikacija pri prijemu bila je pneumotoraks (47,1%; p<0,001). Najčešći način liječenja komplikacija bila je suportivna terapija (60,8%), dok je drenaža bila zastupljena u 37,3% slučajeva, a punkcija u samo 1,96% slučajeva (p<0,001).
Zaključak: Prijelom rebara je znak teške traume. S obzirom da su 29,3% bolesnika imali razvijene komplikacije pri prijemu te da je manji broj bolesnika razvio komplikacije tijekom liječenja, bez obzira na dob i broj slomljenih rebara svi bolesnici s prijelomom rebara bi trebali biti primljeni na bolničko liječenje. |
Abstract (english) | Objectives: The aim of this study was to compare epidemiological, demographic and clinical characteristics, treatment outcomes, and to determine the need for hospitalization in patients treated for rib fractures.
Patients and methods: All subjects included in the study were treated for rib fracture at the Department of Thoracic Surgery in the period from January 1st, 2019. to December 31st, 2019. The subjects were analysed according to the following parameters: age, gender, number of broken ribs, complications during admission, complications during treatment, method of treatment and length of hospitalization.
Results: During 2019, in the Department of Thoracic Surgery of the University Hospital of Split 174 patients were treated for rib fractures (36.2% of women and 63.8% of men). Most patients had a serial rib fracture (n=121; 69.5%). Most patients did not have complications at admission (70.7%; p<0.001). The mean age was six years higher in patients who did not have complications at admission compared to patients who had complications at admission, (p=0.054). The median length of hospitalization was five (IQR 4, 6) days, while the median length of hospitalization was two days longer in patients with complications compared to patients without complications (p<0.001). Most patients who did not have complications at admission did not develop complications by the end of treatment (p<0.001). The most common complication at admission was pneumothorax (47.1%; p<0.001). The most common treatment for complications was supportive therapy (60.8%), while drainage was performed in 37.3% of cases and puncture in only 1.96% of cases (p <0.001).
Conclusion: A rib fracture is a sign of severe trauma. Given that 29.3% of patients had developed complications at admission and that a smaller number of patients developed complications during treatment, regardless of age and number of broken ribs, all patients with rib fractures should be admitted to hospital. |