A MULTICENTER EVALUATION OF THE OPTIMAL TIMING OF SURGICAL STABILIZATION OF RIB FRACTURES.

Introduction: The optimal timing of surgical stabilization of rib fractures (SSRF) remains debated. We hypothesized that 1) demographic, radiologic, and clinical variables are associated with time to surgery and 2), shorter time to SSRF improves acute outcomes. Methods: Prospectively collected SSRF databases from four trauma centers were merged and analyzed (2006-2016). The independent variable was days from hospital admission to SSRF [early ( 24 hours) mechanical ventilation, pneumonia, tracheostomy, length of stay, and mortality. Multivariable logistic regression was used to control for significant differences in covariates between groups. Results: 551 patients were analyzed. The median time to SSRF was 1 day (range 0-10); 207 (37.6%) patients were in the early group, 168 (30.5%) in the mid group, and 186 (31.9%) in the late group. There was a significant shift towards earlier SSRF over the study period. Time to SSRF was significantly associated with study center (p

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