The Clinical Study Of Surgical Rib Fracture Score To Assist The Treatment Decision Of Rib Fracture

Objective The related factors influencing the surgical treatment of rib fractures were analyzed,and establish a modified surgical prediction scoring system for rib fractures--Surgical Rib Fracture Score(SRFS),to evaluate its accuracy as a surgical indicator for rib fractures.Methods Through the retrospective collection of ingxia medical university general hospital general thoracic surgery in July 2016 to October 2019,the clinical data of 270 patients with fracture of ribs,according to the hospital to accept "ribs" open reduction and internal fixation of fracture is divided into surgical group(n = 135)with the surgical group(n= 135),the treatment and the statistical analysis of clinical data between those who did not make clear the key factors influencing the rib fracture surgery,according to the analysis results in the ribs score(rib score,RS)based on new SRFS score,Receiver operating characteristic curve(ROC)was used to compare the accuracy of SRFS scoring system with existing rib fracture score(RFS),chest wall trauma score(CWTS),chest trauma score(CTS)and RS score in predicting rib fracture surgery.Results 1.The single factor analysis of the results that the operative group had a higher number or rate than the non-operative group in the number of rib fractures,serious displacement of fracture number,the incidence of flail chest,the first rib fracture incidence and total fracture of a rib incidence,the difference was statistically significant(P < 0.05);the multi-factor logistic regression analysis results suggest flail chest and ribs root number 6 or higher root,displacement of fracture number 2 or higher is fractured ribs should be independent risk factors for surgical treatment(P < 0.05);2.The established SRFS scoring factors included:(1)flailing chest,(2)the number of rib fractures ≥6,(3)the number of displaced fractures ≥2.Each of the above factors was given 1 point,with the maximum of 3points.When the SRFS score ≥2 points,it suggested the necessity of surgical treatment for rib fractures.3.The surgical SRFS scoring average(2.40)is significantly higher than those who did not SRFS scoring average(0.56),statistically significant(P < 0.05),SRFS score area under the ROC curve(c = 0.926)significantly greater than the RFS score(c = 0.895),CWTS score(c = 0.656),the CTS grade(c = 0.669)and RS(c = 0.895),for rib fracture surgery prediction with high accuracy.Conclusion 1.The flail chest and rib fractures ≥6 and the number of displaced fractures ≥2 were independent risk factors for rib fractures requiring surgical treatment;2.The established SRFS scoring factors included:(1)flailing chest,(2)the number of rib fractures ≥6,(3)the number of displaced fractures ≥2.Each of the above factors was given 1 point,with the maximum of 3 points.When the SRFS score ≥2 points,it suggested the necessity of surgical treatment for rib fractures;3.SRFS scoring system has a high predictive value for rib fracture surgery and can accurately evaluate the surgical treatment of rib fracture.