{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:31:00Z","timestamp":1786516260594,"version":"build-2736575974"},"reference-count":15,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"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":["J Int Med Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rib fractures are a common cause of hospitalisation in the adult trauma population and are associated with significant morbidity and mortality. This study aimed to assess the efficacy of a bundle of care known as the \u2018rib fracture pathway\u2019 in improving patient-centred outcomes and health economic outcomes in an Australian tertiary trauma hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre retrospective cohort study analysed prospectively collected pain registry data from 2004 to 2022, encompassing the period before and after the implementation of the rib fracture pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The implementation of a rib fracture pathway was not associated with a reduction in patient reported pain scores at rest or on movement. Post-implementation, patients were more likely to receive a regional nerve block (56.7% vs. 10.4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Despite this, length of hospital stay was increased post-implementation (8.9 vs. 8.1 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.01), and duration of Acute Pain Service follow-up increased (3.8 vs. 3.0 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The lengthier hospital stay persisted in patients with &gt;2 rib fractures (8 vs. 7 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that the implementation of a rib fracture pathway was not associated with clear improvements in patient-centred outcomes and was associated with adverse health economic outcomes, including increased length of hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261471253","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:37:27Z","timestamp":1785508647000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a rib fracture management pathway in an Australian tertiary trauma hospital"],"prefix":"10.1177","volume":"54","author":[{"given":"Craig","family":"Morrison","sequence":"first","affiliation":[{"name":"Flinders Medical Centre"},{"name":"Flinders University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara","family":"Song","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre"},{"name":"Flinders University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Soon","family":"Cheok","sequence":"additional","affiliation":[{"name":"Flinders University"},{"name":"Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Liew","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohen","family":"Skiba","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Rice","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruurd L","family":"Jaarsma","sequence":"additional","affiliation":[{"name":"Flinders University"},{"name":"Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidde M","family":"Kroon","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0813-3161","authenticated-orcid":false,"given":"D-Yin","family":"Lin","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre"},{"name":"Flinders University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199412000-00018"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(03)00256-2"},{"key":"e_1_3_3_4_2","volume-title":"Acute pain management: scientific evidence","author":"Schug SA","year":"2020","unstructured":"Schug SA, Palmer GM, Scott DA, et al. Acute pain management: scientific evidence. 5th ed. Melbourne: Australian and New Zealand College of Anaesthetists, 2020.","edition":"5"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-023-01172-9"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.18.089"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000451"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01875-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005730"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14579"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2022.110940"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348221091956"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.09.068"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.04.020"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.08.029"},{"key":"e_1_3_3_16_2","doi-asserted-by":"crossref","DOI":"10.4081\/ecj.2019.7716","article-title":"Levobupivacaine combined with dexamethasone for serratus plane block can provide long-lasting analgesia in multiple rib fractures.","volume":"15","author":"Di Pietro S","year":"2019","unstructured":"Di Pietro S, et al. Levobupivacaine combined with dexamethasone for serratus plane block can provide long-lasting analgesia in multiple rib fractures. Emerg Care J 2019; 15: 1\u20133.","journal-title":"Emerg Care J"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261471253","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605261471253","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261471253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:56:27Z","timestamp":1786514187000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605261471253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/03000605261471253"],"URL":"https:\/\/doi.org\/10.1177\/03000605261471253","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"article-number":"03000605261471253"}}