Abstract

This study aimed to evaluate rib fracture rate as well as rib fracture characteristics after thoracic trauma in patients with normal versus diminished bone mineral density (BMD). A retrospective cohort study of persons aged 50 years or older presenting to the Emergency Department after sustaining blunt thoracic trauma between July 1, 2014, and December 31, 2017, was performed. Patient and trauma characteristics and DXA scan results were collected. Rib fracture rate and characteristics were evaluated on a radiograph and/or CT scan of the thorax. In total, 119 patients were included for analysis. Fifty-eight of them (49%) had a diminished BMD. In the remaining 61, the BMD was normal. The diminished BMD group experienced rib fractures more often than the normal BMD group (n = 43 (74%) versus n = 31 (51%); p = 0.014). Patients with diminished BMD suffered low-energy trauma more frequently than the normal BMD group (21 (36%) versus 11 patients (15%), respectively (p = 0.011)). Rib fracture characteristics such as the median number of rib fractures, concomitant intrathoracic injury rate, and rib fracture type distribution were not different between the groups. The rate of rib fractures after blunt thoracic trauma was significantly higher in patients with diminished BMD than in patients with a normal BMD. Differences in number and location of rib fractures between groups could not be proven. When assessing patients aged 50 years or older presenting to the hospital after substantial blunt thoracic trauma, the presence of diminished BMD should be taken into account and the presence of rib fractures should be investigated with appropriate diagnostic procedures. Diminished bone mineral density (i.e., osteopenia or osteoporosis) is associated with increased fracture risk. This study evaluated if diminished BMD increases the rib fracture risk. Patients with diminished BMD have a higher risk of sustaining rib fractures after substantial blunt thoracic trauma, which implicates a lower threshold for CT imaging of the chest.

中文翻译：

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骨密度正常与骨密度降低的患者钝性胸外伤后肋骨骨折：一项回顾性队列研究

摘要

这项研究的目的是评估骨矿物质密度（BMD）正常与降低的患者胸外伤后的肋骨骨折率以及肋骨骨折特征。在2014年7月1日至2017年12月31日期间遭受钝性胸外伤后向急诊科就诊的50岁或50岁以上人群进行了一项回顾性队列研究。收集患者和创伤特征以及DXA扫描结果。肋骨骨折率和特征通过胸部的X线照片和/或CT扫描进行评估。总共包括119位患者进行了分析。其中有58个（49％）的BMD降低了。在其余的61例中，BMD正常。所述减弱BMD组经历肋骨骨折往往比正常BMD组（Ñ = 43（74％）与Ñ= 31（51％）；p = 0.014）。BMD降低的患者比正常BMD组遭受低能量创伤的频率更高（分别为21（36％）和11位患者（15％）（p= 0.011））。两组之间的肋骨骨折特征如肋骨骨折的中位数，伴随的胸腔内损伤率和肋骨骨折的类型分布无差异。BMD减低的患者胸廓钝性创伤后肋骨骨折的发生率明显高于BMD正常的患者。两组之间肋骨骨折的数量和位置均无法证明。在评估严重钝性胸外伤后到医院就诊的50岁或50岁以上的患者时，应考虑骨密度​​降低的存在，并应采用适当的诊断程序对肋骨骨折的存在进行调查。骨矿物质密度降低（即骨质减少或骨质疏松）与骨折风险增加相关。这项研究评估了骨密度降低是否会增加肋骨骨折的风险。BMD降低的患者在遭受实质性钝性胸外伤后，更有可能承受肋骨骨折，这意味着胸部CT成像的阈值较低。