ALiEM - By Christina shenvi - June 3rd, 2015
"SUMMARY
Mortality in patients with rib fractures is high in older adults (20% mortality with 3-4 fractures).
Risk factors for death include age >65 years, ≥3 fractures, underlying CHF, and development of pneumonia.
In older adults with blunt chest trauma, have a low threshold for admission for patients with multiple fractures to optimize analgesia and pulmonary therapy.
The data currently does not clearly support an advantage of epidural analgesia compared with IV opioids. A multidisciplinary approach with nursing, PT, OT, and RT to optimize pain control and pulmonary function can reduce mortality and hospital/ICU LOS."
http://www.aliem.com/rib-fractures-in-older-adults-whats-the-big-deal/