Factors Influencing Vizient Length of Stay Index Following Surgical Stabilization of Rib Fractures

Introduction: Surgical stabilization of rib fractures (SSRF) has shown variable impact on hospital length of stay (LOS). Vizient is a national organization that provides detailed quality data, including the LOS index, benchmarked to comparable size and acuity health systems. We identified predictors of lower LOS index among patients undergoing SSRF at our institution to guide future quality initiatives within this patient population.

Methods: We performed a retrospective analysis of patients undergoing SSRF from November 2021 to May 2023. We obtained each patient's LOS index based on relevant clinical conditions and cross-referenced it with the Chest Injury International Database institutional data. We also performed benchmark comparisons for similar academic medical centers. The primary outcome was the LOS index.

Results:  Fifty-four patients were identified with a median LOS index of 0.70 (range:0.1-4.5). Median age was 60 yrs (range:21-83 yrs), and 16 (30%) were female. Falls were common (n=22, 41%), and the median injury severity score was 16 (range:4-57). On multivariate analysis, higher BMI (aOR:1.4; 95% confidence interval [CI]:1.1-1.8) and presence of polytrauma (aOR:24.1; 95%CI:1.6-359.3) were found to be associated with a longer LOS index.

Conclusion: Patients with higher BMI and polytrauma were more likely to have a longer LOS index. Targeted, early interventions towards patients at risk for higher length of stay after SSRF may be warranted.