{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:49:57Z","timestamp":1793656197939,"version":"4.5.1"},"reference-count":52,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Studies have shown an increased risk of morbidity in elderly patients suffering rib fractures from blunt trauma. The association between frailty and rib fractures on adverse outcomes is still ill-defined. In the current investigation, we sought to delineate the association between frailty, measured using the Orthopedic Frailty Score (OFS), and outcomes in geriatric patients with isolated rib fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All geriatric (aged 65 years or older) patients registered in the 2013\u20132019 Trauma Quality Improvement database with a conservatively managed isolated rib fracture were considered for inclusion. An isolated rib fracture was defined as the presence of \u22651 rib fracture, a thorax Abbreviated Injury Scale (AIS) between 1 and 5, an AIS \u22641 in all other regions, as well as the absence of pneumothorax, hemothorax, or pulmonary contusion. Based on patients\u2019 OFS, patients were classified as non-frail (OFS 0), pre-frail (OFS 1), or frail (OFS \u22652). The prevalence ratio (PR) of composite complications, in-hospital mortality, failure-to-rescue (FTR), and intensive care unit (ICU) admission between the OFS groups was determined using Poisson regression models to adjust for potential confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 65\u2009375 patients met the study\u2019s inclusion criteria of whom 60% were non-frail, 29% were pre-frail, and 11% were frail. There was a stepwise increased risk of complications, in-hospital mortality, and FTR from non-frail to pre-frail and frail. Compared with non-frail patients, frail patients exhibited a 87% increased risk of in-hospital mortality [adjusted PR (95% CI): 1.87 (1.52-2.31), p&lt;0.001], a 44% increased risk of complications [adjusted PR (95% CI): 1.44 (1.23-1.67), p&lt;0.001], a doubling in the risk of FTR [adjusted PR (95% CI): 2.08 (1.45-2.98), p&lt;0.001], and a 17% increased risk of ICU admission [adjusted PR (95% CI): 1.17 (1.11-1.23), p&lt;0.001].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a strong association between frailty, measured using the OFS, and adverse outcomes in geriatric patients managed conservatively for rib fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tsaco-2023-001206","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T01:35:24Z","timestamp":1707356124000},"page":"e001206","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Investigating the link between frailty and outcomes in geriatric patients with isolated rib fractures"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-487X","authenticated-orcid":false,"given":"Shahin","family":"Mohseni","sequence":"first","affiliation":[{"name":"Orebro universitet Fakulteten for medicin och halsa, Orebro, Sweden"},{"name":"Department of Surgery, Sheikh Shakhbout Medical City\u2014Mayo Clinic, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-3443","authenticated-orcid":false,"given":"Maximilian Peter","family":"Forssten","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Orebro University Hospital, Orebro, Sweden"},{"name":"School of Medical Sciences, Orebro University, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3436-1026","authenticated-orcid":false,"given":"Ahmad","family":"Mohammad Ismail","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Orebro University Hospital, Orebro, Sweden"},{"name":"School of Medical Sciences, Orebro University, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Orebro University, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-3004","authenticated-orcid":false,"given":"Babak","family":"Sarani","sequence":"additional","affiliation":[{"name":"George Washington University, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Marcelo AF","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sheikh Shakhbout Medical City\u2014Mayo Clinic, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"2025081711155085000_9.1.e001206.1","unstructured":"United Nations, Department of Economic and Social Affairs . 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