Abstract
BACKGROUND: This study aims to assess the collective influence of inflammatory indicators and surgical interventions on the one-month postoperative recovery outcomes in patients with rib fractures. METHODS: A retrospective analysis involved 70 surgical and 278 non - surgical rib - fracture patients. Primary outcomes were thoracic complication incidence and post - discharge oral analgesic use at one month. Secondary outcomes included hospital stay length and total costs. We collected various data and conducted propensity score matching (1:2 ratio) to control for confounders, followed by multivariate analyses. RESULTS: After PSM (60 surgical vs. 117 non-surgical patients), surgical reduced hospital stay by 10.4 days (β = -10.36 days, 95 % confidence interval [95 % CI]: -16.03 to -4.70; P < 0.001), but increase in total costs by 30,808.80 CNY (P < 0.001). Pre-existing thoracic complications independently predicted higher one-month postoperative complications (OR[95 % CI] = 4.05 [1.08, 18.15]; P = 0.048), while comorbidities lowered risk (OR[95 %CI] = 0.29 [0.08, 0.89]; P = 0.043). Elevated systemic immune-inflammation index (SII) (Coef [95 % CI] = 528.03 [28.05, 1028.00]; P = 0.039) and neutrophil-to-lymphocyte ratio (NLR) (Coef[95 % CI] = 3.50 [0.62, 6.37]; P = 0.017) were positively correlated with Injury Severity Score (ISS). In surgical patients, a higher lymphocyte-to-monocyte ratio (LMR) independently predicted a lower likelihood of ongoing analgesic use at one month (OR[95 %CI] = 0.70 [0.46, 0.95]; P = 0.046). CONCLUSION: Surgical rib - fracture stabilization shortens hospital stay but raises treatment costs. High SII and NLR, along with thoracic complications, are linked to post - op complications. LMR and HGB levels are associated with analgesic needs, which may aid in tailored pain management.