Thinking of a patient in totality - including the above factors and the patient's pulmonary function, mobility and resources - will provide the best care. Health status before injuryĭue to variations in older adults' vigor prior to fracture, a robust 70-year-old with four rib fractures may fare well post-injury, while a 60-year-old with two rib fractures and multiple comorbidities may need transfer to a Level I Trauma Center.
Kim points out that one simple rib fracture in a 90-year-old may put the individual at as much risk as would eight rib fractures in a 40-year-old. With four or more ribs fractured, mortality increases significantly, according to the 2004 study. Older trauma patients sustaining rib fracture may have one broken rib or polytrauma. The following factors are essential to consider when assessing elderly patients presenting with rib fracture: Spectrum of injury In other words, individualization and tailoring of care are critical for geriatric patients with this injury. Kim explains that in many ways, managing trauma-related rib fracture in an elderly patient - and thus averting respiratory complications such as pneumonia - is more art than science. Factors to consider with patients with rib fractureĭr. Though rib fractures elevate pneumonia risk in all age groups, older adults are at higher risk than those who are younger. "You can imagine a set of broken ribs on top of a cough," says Dr. To avoid intensifying discomfort, patients' breathing becomes shallower and they repress coughing, leading to respiratory insufficiency.
When patients sustain a rib fracture, pain may preclude normal breathing or secretion clearing. "Some elderly adults are extraordinarily healthy and fall clearing snow on a 10-foot ladder, fracturing one or more ribs." Breathing risks from rib fracture Kim, M.D., a trauma surgeon at Mayo Clinic's campus in Rochester, Minnesota, conceding that not all older adults have the same risk factors. "All of these factors are a potentially lethal combination for rib fracture for the elderly individual," says Brian D. A 2004 study published in Journal of the American Geriatrics Society also confirmed increased mortality in older adults sustaining rib fracture.Ī variety of factors contribute to rib fracture risk in older adults, such as polypharmacy, chronic health conditions, frailty, increased proneness to dehydration and decreased self-awareness. According to a study published in the June 2000 issue of the Journal of Trauma: Injury, Infection, and Critical Care, mortality and thoracic morbidity doubles in geriatric patients with rib fracture compared with younger counterparts.
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