{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:45:04Z","timestamp":1777448704370,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to compare in-hospital outcomes and mortality in patients with and without a psychiatric comorbidity that presented to a trauma center with isolated blunt chest trauma and multiple traumatic rib fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This is retrospective analysis using the American College of Surgeons Trauma Quality Improvement Program database (2014-2016). Patients \u226518\u00a0years with \u22653 traumatic rib fractures were stratified based on the presence or absence of a psychiatric comorbidity. In-hospital complications, length of stay, intensive care unit (ICU) admission, and mortality were assessed. Variables significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) on univariate analysis were entered into logistic regression models to determine the independent effect of a psychiatric comorbidity on outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 56,558 patients meeting inclusion criteria, 10.6% (n = 6022) had a psychiatric comorbidity. On univariate analysis, patients with a psychiatric comorbidity demonstrated significantly worse in-hospital outcomes, including higher rates of acute respiratory distress syndrome (ARDS) (1.0% vs 0.7%), deep vein thrombosis (DVT) (1.5% vs 1.2%), pulmonary embolism (PE) (0.8% vs 0.5%), pneumonia (4.2% vs 3.1%), urinary tract infection (2.4% vs 1.7%), and decreased mortality (2.2% vs 3.5%). After controlling for comorbidities, substance use, and demographic factors, psychiatric comorbidity was an independent predictor of ARDS (aOR 1.15,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), DVT (OR 1.32,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017), PE (aOR 1.40,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004), pneumonia (aOR 1.36,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and decreased mortality (aOR 0.71,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The presence of a psychiatric comorbidity increases in-hospital complications independent of patient characteristics, comorbidities, and trauma burden in patients presenting with multiple traumatic rib fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251388956","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:22:47Z","timestamp":1760620967000},"page":"1145-1152","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Psychiatric Illness on Clinical Outcomes of Patients With Multiple Rib Fractures: Insights From a National Trauma Database"],"prefix":"10.1177","volume":"92","author":[{"given":"Danielle","family":"Rowe","sequence":"first","affiliation":[{"name":"Richmond University Medical Center"},{"name":"Western Reserve Care System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelon","family":"Scott","sequence":"additional","affiliation":[{"name":"Richmond University Medical Center"},{"name":"Department of Surgery, Northshore University Hospital\/Long Island Jewish Medical Center, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna","family":"Ruthra","sequence":"additional","affiliation":[{"name":"Richmond University Medical Center"},{"name":"HCA Florida North Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shangar","family":"Muhunthan","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Rubinshteyn","sequence":"additional","affiliation":[{"name":"Richmond University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loren","family":"Harris","sequence":"additional","affiliation":[{"name":"Richmond University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8413-4684","authenticated-orcid":false,"given":"Nisha","family":"Lakhi","sequence":"additional","affiliation":[{"name":"Richmond University Medical Center"},{"name":"New York Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01119-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200006000-00007"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000441"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001301"},{"issue":"1","key":"e_1_3_3_6_2","first-page":"46","article-title":"Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries","volume":"5","author":"Dunham CM","year":"2015","unstructured":"Dunham CM, Hileman BM, Ransom KJ, Malik RJ. Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries. Int J Burns Trauma. 2015;5(1):46-55.","journal-title":"Int J Burns Trauma"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.26500"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.05.027"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.617"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.06.061"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.852097"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2022-000910"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.05.017"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.05.051"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-015-1104-4"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.1316"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300940"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.05.031"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2010.04.006"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0b013e31825629ee"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-019-0570-y"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0091217421989147"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.02.055"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251388956","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251388956","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251388956","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:42Z","timestamp":1777379922000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251388956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/00031348251388956"],"URL":"https:\/\/doi.org\/10.1177\/00031348251388956","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]}}}