A retrospective analysis of all patient presenting with multiple rib fractures to the emergency room of Penn State Hershey Medical Center between 2010-2012. Patient demographics, cause of fracture, outcomes, chronic medical conditions, vital signs, length of stay, pain levels and treatment, and sequelae will be recorded and analyzed.

This is a retrospective chart review with follow-up phone calls.

The initial part of the study will be a retrospective chart review. For this chart review study, the following data elements will be entered for each participant.

The investigators will perform a retrospective study of patients who have been treated for rib fractures at Penn State Hershey Medical Center (PSHMC). The time period of review will be 1/10/10 - 1/10/12 until 1500 cases have been reviewed. Data collected will be:

• Patient Medical Record Number (MRN)

• Name

• Phone number

• length of stay (admit and discharge date)

• Number of rib fractures per patient

• Cause of rib fracture

• Characteristics of the fracture (unilateral versus bilateral and multiple versus single)

• Pain management used for the rib fracture including pain interventions, medications and all pain scores

• Complications attributable to the rib fracture, including:

  1. Shortness of Breath (SOB)
  2. Hemothorax,
  3. Pneumothorax
  4. Flail chest
  5. Intubation required
  6. Mechanical ventilation required
  7. Opioids required for pain
  8. Chest tube placement required

• Sequelae of rib fracture, including:

  1. Acute Respiratory Deficiency Syndrome (ARDS)
  2. Pneumonia
  3. Death
  4. chronic pain
  5. delayed subclavian vessel thrombosis
  6. aortic aneurysm
  7. tracheobronchial fistula
  8. thoracic outlet syndrome
  9. Horner's syndrome

• Clinical history of

  1. Rib fractures
  2. Other fractures
  3. Osteoporosis
  4. Chronic Obstructive Pulmonary Disease (COPD)
  5. Cancer
  6. Myocardial Infarction (MI) / Coronary Artery Disease (CAD)
  7. Arthritis
  8. Parkinson's disease

• Patient characteristics:

  1. Age
  2. Gender
  3. Race
  4. Body Mass Index (BMI)
  5. Alcohol use
  6. Smoking status
  7. Marital status
  8. Education
  9. Initial blood pressure

7.2.2 Follow-up phone calls

The investigators will then attempt to call the patients for follow-up information using a summary explanation of research phone script to obtain the following information:

1. pain score
2. quality of life via the EuroQol's quality of life survey :EQ-5D-3L questionnaire
3. pain meds

Inclusion Criteria:

• must have above and be notated in our medical record

Exclusion Criteria:

• missing data

All patients presenting during 2010-2012 with multiple rib fractures to PSHMC emergency department