ORIGINAL RESEARCH article
Front. Surg.
Sec. Thoracic Surgery
Clinical application of a novel rib fracture score system in patients with multiple rib fractures
Provisionally accepted
- 1Beijing Chest Hospital, Capital Medical University, Beijing, China
- 2Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objectives: To validate a new type of rib fracture score system for treatment decisions in patients with multiple rib fractures. Methods: This retrospective study included patients admitted with multiple rib fractures from one clinical center between April 2017 and April 2022. Patients were divided into the conservative group and the surgical group based on their management strategy. The patients were assessed using a novel rib fracture score system based on anatomical and pathophysiological characteristics. Results: In a study of 564 patients, 290 underwent surgical treatment while 274 received conservative treatment. Surgical patients had significantly higher satisfaction scores (P < 0.001) and a greater prevalence of chronic diseases (P = 0.022). The optimal satisfaction cut-off was 9.5 points, dividing patients into low score (LS, < 10) and high score (HS, ≥ 10) groups. In the LS group, pneumonia incidence was similar (P > 0.05). However, in the HS group, surgical patients experienced lower pneumonia rates (no pneumonia: 76.1% vs. 11.5%, P < 0.001), reduced ventilator hours (8.1±37.6 vs. 23.7±66.7, P < 0.001), and less opioid use (1.2±1.5 vs. 2.7±2.5 times, P < 0.001). For scores ≥ 15, conservative treatment may lead to increased respiratory complications. Conclusions: Clinical application of the novel rib fracture score system may be efficient in stratifying patients with rib fractures. Patients with a score ≥ 10 may benefit from surgical intervention. Patients with a score ≥ 15 may have a greater risk of respiratory complications during the period of conservative treatment compared with the LS group, suggesting the importance of surgical intervention in such patients.
Keywords: Thoracic Injuries, Rib Fractures, Fracture Fixation, prognosis, Pneumonia
Received: 24 Jun 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Zhang, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhidong Liu, liuzhidong@bjxkyy.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.