{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:57:48Z","timestamp":1793915868218,"version":"4.8.0"},"reference-count":48,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Blunt thoracic trauma is responsible for 35% of trauma-related deaths in the United States and significantly contributes to morbidity and healthcare-related financial strain. The goal of this study was to evaluate factors influencing mortality in patients emergently admitted with the primary diagnosis of blunt chest wall trauma. Methods: Adults emergently admitted for blunt chest trauma were assessed using the National Inpatient Sample Database, 2004\u20132014. Data regarding demographics, comorbidities, and outcomes were collected. Relationships were determined using univariable and multivariable logistic regression models. Results: In total, 1120 adult and 1038 elderly patients emergently admitted with blunt chest trauma were assessed; 46.3% were female, and 53.6% were male. The average ages of adult and elderly patients were 46.6 and 78.9 years, respectively. Elderly and adult patients both displayed mortality rates of 1%. The regression model showed HLOS and several comorbidities as the main risk factors of mortality Every additional day of hospitalization increased the odds of mortality by 9% (OR = 1.09, 95% CI = 1.01\u20131.18, p = 0.033). Mortality and liver disease were significantly associated (OR = 8.36, 95% CI = 2.23\u201331.37, p = 0.002). Respiratory disease and mortality rates demonstrated robust correlations (OR = 7.46, 95% CI = 1.63\u201334.11, p = 0.010). Trauma, burns, and poisons were associated with increased mortality (OR = 3.72, 95% CI = 1.18\u201311.71, p = 0.025). The presence of platelet\/white blood cell disease correlated to higher mortality. (OR = 4.42, 95% CI = 1.09\u201317.91, p = 0.038).<\/jats:p>","DOI":"10.3390\/ijerph19148729","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T11:32:23Z","timestamp":1658143943000},"page":"8729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Major Risk Factors for Mortality in Elderly and Non-Elderly Adult Patients Emergently Admitted for Blunt Chest Wall Trauma: Hospital Length of Stay as an Independent Predictor"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9757-207X","authenticated-orcid":false,"given":"Guy","family":"Elgar","sequence":"first","affiliation":[{"name":"Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0590-0553","authenticated-orcid":false,"given":"Abbas","family":"Smiley","sequence":"additional","affiliation":[{"name":"Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rifat","family":"Latifi","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Arizona, Tucson, AZ 85724, USA"},{"name":"Ministry of Health, 10000 Pristina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"ref_1","unstructured":"Edgecombe, L., Sigmon, D.F., Galuska, M.A., and Angus, L.D. (2022, March 14). Thoracic Trauma, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534843\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.cjtee.2020.04.003","article-title":"Blunt trauma related chest wall and pulmonary injuries: An overview","volume":"23","author":"Dogrul","year":"2020","journal-title":"Chin. J. Traumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3265","DOI":"10.1053\/j.jvca.2022.02.010","article-title":"Echocardiography and Management for Cardiac Trauma","volume":"36","author":"Latif","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Roy, N., Veetil, D.K., Khajanchi, M.U., Kumar, V., Solomon, H., Kamble, J., Basak, D., Tomson, G., and Von Schreeb, J. (2017). Learning from 2523 trauma deaths in India- opportunities to prevent in-hospital deaths. BMC Health Serv. Res., 17.","DOI":"10.1186\/s12913-017-2085-7"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1757-7241-20-63","article-title":"Systematic review of predictive performance of injury severity scoring tools","volume":"20","author":"Tohira","year":"2012","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13017-020-00324-1","article-title":"Analysis of risk factors in thoracic trauma patients with a comparison of a modern trauma centre: A mono-centre study","volume":"15","author":"Beshay","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.injury.2011.01.004","article-title":"Risk factors that predict mortality in patients with blunt chest wall trauma: A systematic review and meta-analysis","volume":"43","author":"Battle","year":"2012","journal-title":"Injury"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/s1010-7940(02)00813-8","article-title":"Chest injury due to blunt trauma","volume":"23","author":"Liman","year":"2003","journal-title":"Eur. J. Cardio Thoracic Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1001\/archsurg.2010.71","article-title":"Factors Associated with Survival Following Blunt Chest Trauma in Older Patients","volume":"145","author":"Harrington","year":"2010","journal-title":"Arch. Surg."},{"key":"ref_10","first-page":"8","article-title":"Prognostic Factors in Blunt Chest Trauma. Analysis of 652 Cases","volume":"75","author":"Svennevig","year":"1996","journal-title":"Ann. Chir. Gynaecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13017-022-00416-0","article-title":"Lung failure after polytrauma with concomitant thoracic trauma in the elderly: An analysis from the TraumaRegister DGU\u00ae","volume":"17","author":"Vollrath","year":"2022","journal-title":"World J. Emerg. Surg."},{"key":"ref_12","first-page":"440","article-title":"Effect of Presence of Rib Fracture on Mortality and Morbidity in Blunt Thoracic Traumas","volume":"28","year":"2020","journal-title":"Turk. J. Trauma Emerg. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1177\/000313480006600912","article-title":"Blunt chest trauma in the elderly patient: How cardiopulmonary disease affects outcome","volume":"66","author":"Alexander","year":"2000","journal-title":"Am. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.cjtee.2017.04.011","article-title":"Predicting mortality, hospital length of stay and need for surgery in pediatric trauma patients","volume":"20","author":"Chabok","year":"2017","journal-title":"Chin. J. Traumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1177\/00031348211060420","article-title":"Independent Predictors of In-Hospital Mortality in Elderly and Non-elderly Adult Patients Undergoing Emergency Admission for Hemorrhoids","volume":"88","author":"Levy","year":"2022","journal-title":"Am. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1177\/00031348211054074","article-title":"Risk Factors of Mortality in Patients Hospitalized with Chronic Duodenal Ulcers","volume":"88","author":"Lin","year":"2022","journal-title":"Am. Surg."},{"key":"ref_17","first-page":"206","article-title":"Delayed Operation as a Major Risk Factor for Mortality Among Elderly Patients with Ventral Hernia Admitted Emergently: An Analysis of 33,700 Elderly Patients","volume":"39","author":"Latifi","year":"2021","journal-title":"Surg. Technol. Online"},{"key":"ref_18","first-page":"183","article-title":"Risk Factors for Mortality in Patients with Ventral Hernia Admitted Emergently: An Analysis of 48,539 Adult Patients","volume":"39","author":"Smiley","year":"2021","journal-title":"Surg. Technol. Online"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Murni, I.K., Duke, T., Kinney, S., Daley, A.J., Wirawan, M.T., and Soenarto, Y. (2022). Risk factors for healthcare-associated infection among children in a low-and middle-income country. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07387-2"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.injury.2015.02.024","article-title":"Influence of access to an integrated trauma system on in-hospital mortality and length of stay","volume":"46","author":"Kuimi","year":"2015","journal-title":"Injury"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/SLA.0000000000000624","article-title":"Hospital Length of Stay After Admission for Traumatic Injury in Canada","volume":"260","author":"Moore","year":"2014","journal-title":"Ann. Surg."},{"key":"ref_22","first-page":"126","article-title":"Independent Predictors of In-Hospital Mortality in Patients Undergoing Emergency Admission for Arterial embolism and Thrombosis in the USA: A 10-Year National Dataset","volume":"3","author":"Levy","year":"2021","journal-title":"Kos. Med. J."},{"key":"ref_23","first-page":"1612","article-title":"Mortality in Emergently Admitted Patients with Empyema: An Analysis of 18,033 Patients","volume":"8","author":"Levy","year":"2021","journal-title":"Kos. Med. J."},{"key":"ref_24","first-page":"604","article-title":"The Impact of Malnutrition on Morbidity, Mortality and Length of Hospital Stay in Trauma Patients","volume":"21","author":"Goiburu","year":"2006","journal-title":"Nutr. Hosp."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Degirmenci, M. (2022). Factors related to clinical outcomes in blunt thoracic injuries. Gen. Thorac. Cardiovasc. Surg., 1\u20138.","DOI":"10.1007\/s11748-022-01796-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13049-014-0052-4","article-title":"Predictors of poor outcomes after significant chest trauma in multiply injured patients: A retrospective analysis from the German Trauma Registry (Trauma Register DGU\u00ae)","volume":"22","author":"Huber","year":"2014","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ciresp.2009.11.020","article-title":"Factores pron\u00f3stico del traumatismo tor\u00e1cico: Estudio prospectivo de 500 pacientes","volume":"87","author":"Perna","year":"2010","journal-title":"Cirug\u00eda Espa\u00f1ola"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/MCC.0b013e32835ebb52","article-title":"Coagulation pattern in critical liver dysfunction","volume":"19","author":"Schaden","year":"2013","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-2002-23205","article-title":"Coagulation Disorders in Liver Disease","volume":"22","author":"Amitrano","year":"2002","journal-title":"Semin. Liver Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1007\/s00268-016-3865-7","article-title":"Strategies for Intravenous Fluid Resuscitation in Trauma Patients","volume":"41","author":"Wise","year":"2017","journal-title":"World J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12245-019-0253-8","article-title":"Fluid resuscitation in trauma: What are the best strategies and fluids?","volume":"12","author":"Ramesh","year":"2019","journal-title":"Int. J. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s13054-016-1341-2","article-title":"Early changes within the lymphocyte population are associated with the development of multiple organ dysfunction syndrome in trauma patients","volume":"20","author":"Manson","year":"2016","journal-title":"Crit. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jss.2021.09.013","article-title":"Admission Lymphopenia is Associated with Discharge Disposition in Blunt Chest Wall Trauma Patients","volume":"270","author":"Koch","year":"2021","journal-title":"J. Surg. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00068-015-0585-x","article-title":"Persistent lymphopenia is an independent predictor of mortality in critically ill emergency general surgical patients","volume":"42","author":"Vulliamy","year":"2015","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"R12","DOI":"10.1186\/cc11157","article-title":"Failure to Normalize Lymphopenia Following Trauma Is Associated with Increased Mortality, Independent of the Leukocytosis Pattern","volume":"16","author":"Heffernan","year":"2012","journal-title":"Crit. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1097\/01.TA.0000029382.26295.AB","article-title":"The Risk Factors and Time Course of Sepsis and Organ Dysfunction after Burn Trauma","volume":"54","author":"Fitzwater","year":"2003","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1056\/NEJM199802053380604","article-title":"Objective Estimates of the Probability of Death from Burn Injuries","volume":"338","author":"Ryan","year":"1998","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.burns.2009.04.015","article-title":"Characteristics and outcomes of multiple organ dysfunction syndrome among severe-burn patients","volume":"35","author":"Nguyen","year":"2009","journal-title":"Burns"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lucena-Amaro, S., Cole, E., and Zolfaghari, P. (2022). Long term outcomes following rib fracture fixation in patients with major chest trauma. Injury.","DOI":"10.1016\/j.injury.2022.04.020"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.injury.2019.10.030","article-title":"Epidemiology of adult rib fracture and factors associated with surgical fixation: Analysis of a chest wall injury dataset from England and Wales","volume":"51","author":"Ingoe","year":"2019","journal-title":"Injury"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1510\/icvts.2005.111807","article-title":"Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status","volume":"4","author":"Granetzny","year":"2005","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/XCS.0000000000000078","article-title":"Role of Fibrinogen in Trauma-Induced Coagulopathy","volume":"234","author":"Meizoso","year":"2022","journal-title":"J. Am. Coll. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1016\/j.injury.2016.11.021","article-title":"Fibrinogen is an independent predictor of mortality in major trauma patients: A five-year statewide cohort study","volume":"48","author":"McQuilten","year":"2016","journal-title":"Injury"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40560-016-0196-6","article-title":"Acute traumatic coagulopathy and trauma-induced coagulopathy: An overview","volume":"5","author":"Kushimoto","year":"2017","journal-title":"J. Intensive Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/01.TA.0000075338.21177.EF","article-title":"Early Coagulopathy Predicts Mortality in Trauma","volume":"55","author":"MacLeod","year":"2003","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.injury.2010.11.003","article-title":"Early coagulopathy in trauma patients: An on-scene and hospital admission study","volume":"43","author":"Floccard","year":"2012","journal-title":"Injury"},{"key":"ref_47","first-page":"827","article-title":"Acute Traumatic Coagulopathy in Severe Injury","volume":"108","author":"Maegele","year":"2011","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1097\/MCC.0b013e3282f1e78f","article-title":"Acute coagulopathy of trauma: Mechanism, identification and effect","volume":"13","author":"Brohi","year":"2007","journal-title":"Curr. Opin. Crit. Care"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/14\/8729\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:52:54Z","timestamp":1760140374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/14\/8729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,18]]},"references-count":48,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ijerph19148729"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19148729","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,18]]}}}