Evaluation of Clinical Outcomes in Trauma Patients with Minimal Pneumothorax and Rib Fractures: A 48-Hour Observation Approach

Abstract

Objectives: This study aims to evaluate the clinical outcomes of trauma patients with minimal pneumothorax, with a specific focus on those with rib fractures. The primary objective is to assess whether a minimum 48-hour observation period is adequate to prevent complications such as recurrent pneumothorax or prolonged air leaks, and to examine the role of early intervention.

Methods: A retrospective study was performed on 185 trauma patients diagnosed with minimal pneumothorax over a five-year period. Among these,83 patients had rib fractures, while 102 did not. Clinical outcomes, including time to tube thoracostomy and the necessity of surgical intervention, were analyzed. Data were compared using chi-square tests, logistic regression models, and Kaplan-Meier survival analysis to determine time-to-intervention trends.

Results: Of the 185 patients, 159 were male and 26 were female, ranging from 19 to 85 years old. Tube thoracostomy was required in 9 patients with rib fractures after an average of 19 hours, while 5 patients without rib fractures required tube thoracostomy after an average of 17 hours. Surgical intervention was necessary for 4 patients due to recurrent pneumothorax or prolonged air leaks, all of whom had rib fractures.

Conclusions: Patients with rib fractures are at increased risk for complications and should be closely monitored for at least 48 hours to detect and manage complications early. Early intervention, particularly tube thoracostomy, may prevent more serious outcomes in patients with rib fractures.