TPT 3.03 Management of Patients with Traumatic Rib Fractures at a District General Hospital

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ID: 323863
2026
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Abstract
Abstract Introduction Traumatic rib fractures are a common consequence of blunt chest wall trauma and are associated with high morbidity and mortality. Delayed onset of respiratory complications is common and may be secondary to inadequate analgesia. Local Trust guidelines specify that all patients should have a risk stratification (STUMBL/Battle) score documented on admission and an appropriate analgesia regimen started. Methods Clinical records of patients with traumatic rib fractures admitted between 13/10/25-29/12/25 under the general surgery team (N=21) at a District General Hospital were reviewed to assess compliance with Trust guidelines and rate of complications. Results Patients had a median age of 81 years; the number of rib fractures ranged from two to ten (median=5) complicated by pneumothorax in 24% (5/21) and haemothorax in 48% (10/21) on presentation. Over half (57%, 12/21) of patients sustained polytrauma. A STUMBL/Battle score was documented for 9.5% (2/21) of patients in the surgical clerking. Analgesia as per local guidelines was prescribed in only 14% (3/21). Of the high-risk patients (Battle score > 16; N=20, 95%), 45% (9/20) were reviewed by anaesthetics within 24h for consideration of regional anaesthesia and one-fifth (4/20) received PCA. Complications during hospital admission were experienced by a third of patients (33%, 7/21). Conclusion Overall compliance with local guidelines on analgesia prescribing is low. Increased multidisciplinary involvement is needed to optimise pain management and may reduce the risk of complications. Review of local guidelines in liaision with anaesthetic and pain services is planned as well as subsequent educational intervention followed by re-audit.
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Authors Amy Huseyin, Marta de Andres Crespo
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.186
URL
https://doi.org/10.1093/bjs/znag087.186
Keywords Keywords not found

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