Three or more rib fractures as an indicator for transfer to a level I trauma center: A population-based study

Robert B. Lee, Sue M. Bass, John A. Morris, Ellen J Mackenzie

Research output: Contribution to journalArticle


The presence of major chest wall injury is an indication for transfer to a Level I trauma center. We hypothesized that the presence of three or more rib fractures on initial chest X-ray would identify a small subgroup of patients with a high probability of requiring trauma center care. All trauma discharges in Maryland between 1984 and 1986 (N=105, 683) were reviewed. Patients were divided by the presence of rib fractures (no rib fractures, 1–2 fractures, 3+ fractures) and age in years (0–13, 14–64, 65+). Results: The presence of three or more rib fractures in the pediatric age group was rare and precluded further evaluation. When comparing patients with 1–2 rib fractures versus 3 or more rib fractures, significant differences were found in mortality, mean Injury Severity Score, mean hospital stay and mean number of ICU days (p

Original languageEnglish (US)
Pages (from-to)689-694
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number6
Publication statusPublished - 1990


ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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