{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T12:41:13Z","timestamp":1793968873119,"version":"4.8.0"},"reference-count":29,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journalofsurgicalresearch.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Research"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.jss.2025.09.051","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T04:03:58Z","timestamp":1760328238000},"page":"443-450","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Rib Fracture Injury Guidelines for Patients Over the Age of 65: Should These Patients Routinely Be Admitted to the Intensive Care Unit?"],"prefix":"10.1016","volume":"315","author":[{"given":"Adam C.","family":"Fields","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3091-9803","authenticated-orcid":false,"given":"Manuel","family":"Castillo-Angeles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Bryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon P.","family":"Bensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin A.","family":"Madenci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Askari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Salim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jss.2025.09.051_bib1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/01.TA.0000037095.83469.4C","article-title":"Elderly trauma patients with rib fractures are at greater risk of death and pneumonia","volume":"54","author":"Bergeron","year":"2003","journal-title":"J Trauma"},{"key":"10.1016\/j.jss.2025.09.051_bib2","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/j.1532-5415.2004.52223.x","article-title":"Rib fractures in the elderlyL a marker of injury severity","volume":"52","author":"Stawicki","year":"2004","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.jss.2025.09.051_bib3","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1097\/00005373-199412000-00018","article-title":"The morbidity and mortality of rib fractures","volume":"37","author":"Ziegler","year":"1994","journal-title":"J Trauma"},{"key":"10.1016\/j.jss.2025.09.051_bib4","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2016-000074","article-title":"Effects of mechanism of injury and patient age on outcomes in geriatric rib fracture patients","volume":"2","author":"Shi","year":"2017","journal-title":"Trauma Surg Acute Care Open"},{"key":"10.1016\/j.jss.2025.09.051_bib5","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/TA.0000000000001330","article-title":"Rib fracture fixation in the 65 years and older population: a paradigm shift in management strategy at a level I trauma center","volume":"82","author":"Fitzgerald","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib6","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1097\/00005373-199006000-00006","article-title":"Three or more rib fractures as an indicator for transfer to a level I trauma center: a population-based study","volume":"30","author":"Lee","year":"1990","journal-title":"J Trauma"},{"key":"10.1016\/j.jss.2025.09.051_bib7","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1097\/00005373-200006000-00007","article-title":"Rib fractures in the elderly","volume":"48","author":"Bulger","year":"2000","journal-title":"J Trauma"},{"key":"10.1016\/j.jss.2025.09.051_bib8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S1072-7515(02)01894-X","article-title":"Morbidity from rib fractures increases after age 45","volume":"196","author":"Holcomb","year":"2003","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.surg.2005.07.022","article-title":"Half-a-dozen ribs: the breakpoint for mortality","volume":"138","author":"Flagel","year":"2005","journal-title":"Surgery"},{"key":"10.1016\/j.jss.2025.09.051_bib10","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.ejcts.2004.04.011","article-title":"Management of 150 flail chest injuries: analysis of risk factors affecting outcome","volume":"26","author":"Athanassiadi","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib11","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.injury.2007.10.021","article-title":"Failed emergency department disposition to the ward of patients with thoracic injury","volume":"39","author":"Blecher","year":"2008","journal-title":"Injury"},{"key":"10.1016\/j.jss.2025.09.051_bib12","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jss.2019.07.098","article-title":"Older adults with isolated rib fractures do not require ourtine intensive care unit admission","volume":"245","author":"Bowman","year":"2020","journal-title":"J Surg Res"},{"key":"10.1016\/j.jss.2025.09.051_bib13","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.surg.2022.07.046","article-title":"Frailty as a predictor of negative outcomes in trauma patients with rib fractures","volume":"173","author":"Feng","year":"2023","journal-title":"Surgery"},{"key":"10.1016\/j.jss.2025.09.051_bib14","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/TA.0000000000001301","article-title":"Western Trauma Association critical decisions in trauma: management of rib fractures","volume":"82","author":"Brasel","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib15","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/TA.0000000000003830","article-title":"Non-surgical management and analgesia strategies for older adults with multiple rib fractures: a systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma and the Chest Wall Injury Society","volume":"94","author":"Mukherjee","year":"2022","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib16","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1097\/TA.0000000000002891","article-title":"Isolated rib cage fractures in the elderly: do all patients belong to the intensive care unit? A retrospective nationwide analysis","volume":"89","author":"Naar","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib18","doi-asserted-by":"crossref","first-page":"2909","DOI":"10.1111\/jgs.16846","article-title":"Association between patient-reported frailty and non-home discharge among older adults undergoing surgery","volume":"68","author":"Sokas","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.jss.2025.09.051_bib19","first-page":"1040","article-title":"A stepwise logistic regression analysis of factors affecting morbidity and mortality after thoracic trauma: effect of epidural analgesia","volume":"48","author":"Wisner","year":"2000","journal-title":"J Trauma"},{"key":"10.1016\/j.jss.2025.09.051_bib20","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.surg.2016.10.018","article-title":"Number of rib fractures thresholds independently predict worse outcomes in older patients with blunt trauma","volume":"161","author":"Shulzhenko","year":"2017","journal-title":"Surgery"},{"key":"10.1016\/j.jss.2025.09.051_bib21","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.amjsurg.2021.07.034","article-title":"Utilizing triage rates to improve ICU admission guidelines of elderly rib fracture patients","volume":"223","author":"Goldstein","year":"2022","journal-title":"Am J Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib22","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1177\/000313481408000827","article-title":"Trauma intensive care unit \u201cbouncebacks\u201d: identifying risk factors for unexpected return admission to the intesive care unit","volume":"80","author":"Christmas","year":"2014","journal-title":"Am Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib23","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/1817-1737.36552","article-title":"Isolated rib fractures in geriatric patients","volume":"2","author":"Elmistekawy","year":"2007","journal-title":"Ann Thorac Med"},{"key":"10.1016\/j.jss.2025.09.051_bib24","series-title":"An aging nation: the older population in the United States","author":"Ortman","year":"2014"},{"key":"10.1016\/j.jss.2025.09.051_bib25","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1097\/TA.0000000000003390","article-title":"Rib fracture frailty index: a risk-stratification tool for geriatric patients with multiple rib fractures","volume":"91","author":"Choi","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jss.2018.04.017","article-title":"Frailty score on admission predicts mortality and dischagre disposition in elderly trauma patients over the age of 65 y","volume":"230","author":"Curtis","year":"2018","journal-title":"J Surg Res"},{"key":"10.1016\/j.jss.2025.09.051_bib27","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/TA.0000000000002666","article-title":"Rib fixation in geriatric trauma: mortality benefits for the most vulnerable patients","volume":"89","author":"Chen","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.jss.2025.09.051_bib28","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1056\/NEJMcp1605501","article-title":"Delirium in hispitalized older adults","volume":"377","author":"Marcantonio","year":"2017","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jss.2025.09.051_bib29","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1056\/NEJMoa1301372","article-title":"BRAIN-ICU Study. Long-term cognitive impairment after critical illness","volume":"369","author":"Pandharipande","year":"2013","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jss.2025.09.051_bib30","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/SLA.0000000000002929","article-title":"Decreased risk of delirium with use of regional analgesia in geriatric trauma patients with multiple rib fractures","volume":"268","author":"O\u2019Connell","year":"2018","journal-title":"Ann Surg"}],"container-title":["Journal of Surgical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022480425006213?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022480425006213?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:30:50Z","timestamp":1780633850000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022480425006213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":29,"alternative-id":["S0022480425006213"],"URL":"https:\/\/doi.org\/10.1016\/j.jss.2025.09.051","relation":{},"ISSN":["0022-4804"],"issn-type":[{"value":"0022-4804","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Rib Fracture Injury Guidelines for Patients Over the Age of 65: Should These Patients Routinely Be Admitted to the Intensive Care Unit?","name":"articletitle","label":"Article Title"},{"value":"Journal of Surgical Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jss.2025.09.051","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}