MDCalc

RibScore

Predicts adverse pulmonary outcomes from rib fracture.

Use to predict adverse outcomes in patients with confirmed rib fractures on imaging.

≥6 fractures

Bilateral fractures

Flail chest

≥3 severely (bicortical) displaced fractures

First rib fracture

≥1 fracture in all three anatomic areas (anterior, lateral, and posterior)

Result:

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Advice

In patients with a RibScore greater than or equal to 4, admit the patient to a monitored bed (e.g. - ICU, stepdown) and treat any pain or respiratory complaints.

Critical Actions

Consider repeat imaging in patients with any of the following as they may be at higher risk for development of delayed hemothorax:

  • Respiratory deterioration.
  • ≥6 rib fractures.
  • Post-operative patients.
  • Anticoagulation.
  • Patients who had a thoracostomy tube placed and then removed.