1264 The Impact of ‘Rib Block’ Administration on Patients with Multiple Rib Fractures at a Major Trauma Centre: A Retrospective Observational Study

Aim

Rib fractures carry a mortality rate of 10% which is doubled in the elderly population. They are common following blunt thoracic trauma and are a marker of injury severity. The timely delivery of regional analgesia is crucial to prevent pain induced hypoxia, atelectasis, pneumonia and respiratory failure.

We compare the trauma-related injuries and outcomes between patients with >2 rib fractures who received regional analgesic blocks with those who didn’t receive blocks.

Method

Retrospective data was collected from 187 patients presenting as a trauma call with >2 rib fractures over a period of 18 months. Patient demographics, ISS, length of stay and respiratory complications were collected from electronic patient records (EPR).

Results

69 patients received a regional rib block compared with 118 who did not. Patients who had a rib block were older compared to those who did not have a block (62.1±17.6 vs 55.4±18.2, p = 0.007). There was no significant difference in number of rib fractures (6.8±3.2, p<0.2), post-admission chest infection rate (23.1±42.5 vs 20.8±40.8, p<0.4), or length of hospital stay (18.7±13.3 vs 21.7±19.1, p<0.2). ISS score was significantly higher in non-blocked patients compared to blocked patients (27.4±14.3 vs 19.5±9.5, p<0.05).

Conclusions

Patients with significantly higher ISS scores did not receive a regional rib block, however this did not appear to impact on post-admission chest infection rate or length of stay. Further work is needed to identify the reasons behind this trend.