Factors influencing Vizient length of stay index after surgical stabilization of rib fractures (SSRF).

Background: Surgical stabilization of ribs (SSRF) has been associated with shorter durations of mechanical ventilation and hospital and intensive care unit lengths of stay (LOS). Vizient is a national organization that provides detailed quality data, including the LOS index, benchmarked to comparable-sized and acuity health systems. Aims: Identify factors associated with shorter and expected LOS index among patients undergoing SSRF. Method: We performed a retrospective review of all adult trauma patients who underwent SSRF from November 2021 to May 2023 at our American College of Surgeons Level 1 trauma center. Logistic regression on key patient characteristics was performed to assess associations with LOS index <1. Results: 37 (69%) patients had an LOS index <1, whereas 17 (32%) had an expected LOS index >1. Patients with a LOS index <1 had lower injury severity scores (ISS) (16.9 SD=11.2 vs 21.7 SD=10.5, p=0.029) and were more commonly working full-time preinjury (n=16, 43%) compared with patients with a LOS index >1 (n=8, 47%, p=0.042). LOS index >1 was also associated with higher body mass index (BMI), government insurance, and polytrauma. Conclusion: Focused, early interventions in patients with higher BMI, polytrauma, and higher ISS scores may help lower the LOS index among patients undergoing SSRF.