Collaborative Trauma Research in New Zealand and the RiBZ Study
Matthew McGuinness1,2, Christopher Harmston1,2, on behalf of STRATA 1. Department of General Surgery, Whangārei Hospital, Northland District Health Board, New Zealand 2. Faculty of Medical and Health Science, University of Auckland, New Zealand
Introduction: Collaborative research facilities improved research quality. Rib fractures are associated with significant morbidity and mortality however there is limited literature on patients care and outcomes in New Zealand.
Aims: Design the first collaborative trauma research project in New Zealand to determine the variation in care and outcomes of patients with rib fractures secondary to isolated blunt thoracic trauma.
Methods: Prospective multicentre observational cohort study. Patients with 1 or more radiologically proven rib fracture and an abbreviated injury score of the head and abdomen <2 admitted between 1 December 2020 and 28 February 2021 were included. Descriptive statistics were used to describe the demographics, management and outcomes.
Results: Thirteen New Zealand Hospitals and 402 patients were included with a mean age of 57.7. 72% were male, 15% Māori and 85% non-Māori. Road traffic crashes were the most common mechanism of injury at 39%. The mean number of rib fractures were 4. 15% had a flail segment, 14% had bilateral rib fracture. Median ISS was 11 (IQR 5). 22% patients received a chest drain, 2% rib plating, 58% a pain team review, 50% a patient control analgesia pump and 23% a regional anaesthetic block or catheter. Mean hospital LOS was 9 days. Mortality rate was 2%, 19% were admitted to ICU, 7% intubated, 11% developed pneumonia and 8% represented within 30-days.
Conclusion: A collaborative research model is a feasible way to improve the reach of trauma research in New Zealand. New Zealand management and outcomes of patients with rib fractures secondary to blunt thoracic trauma is similar to the international literature.