Abstract: Objective · To establish a risk prediction model for pulmonary complications in elderly patients with multiple rib fractures. Methods · A total of 150 cases of elderly patients with multiple rib fractures were analyzed retrospectively January 2016 to December 2017 in the Department of Thoracic Surgery, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine. Patients were divided into case group (n88) and control group (n62) according to whether pulmonary complications occurred. Univariate analysis and Logistic regression analysis were performed based on 8 factors, including gender, age, basic pulmonary disease, smoking history, the number of rib fractures, expectoration, diabetes, and the treatment time. Results · The results of univariate analysis showed that age, basic pulmonary disease, smoking history, the number of rib fractures, expectoration, diabetes, and the treatment time were associated with pulmonary complications (P<0.05). Logistic regression analysis showed that basic pulmonary disease (OR3.338, 95% CI 2.772-11.606, P0.003), smoking history (OR2.407, 95% CI 1.103-5.253, P0.027), the number of rib fractures (OR3.321, 95% CI 1.178-9.359, P0.023), and expectoration (OR4.034, 95% CI 1.818-8.952, P0.001) were the independent risk factors for pulmonary complications in elderly patients with multiple rib fractures. The area under the model ROC curve was 0.816, and the regression model was reliable. Conclusion · Basic pulmonary disease, smoking history, the number of rib fractures and expectoration are the independent risk factors for pulmonary complications in elderly patients with multiple rib fractures. More attention should be paid to these factors into reduce the incidence of pulmonary complications.

Key words: rib fracture, pulmonary complications, elderly patients