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This study examined the impact of frailty on in-hospital outcomes in patients undergoing surgical stabilization of multiple rib fractures and flail chest (SSRF).

This retrospective study used U.S. Nationwide Inpatient Sample data (2005–2020) to analyze patients ≥20 years old who underwent SSRF for multiple rib fractures. In-hospital outcomes (mortality, discharge status, complications) were compared between frail and non-frail groups using 1:4 propensity score matching (PSM).

After PSM, 2690 patients were included in the analyses. Frail patients had a higher likelihood of being transferred to SNF or ICF (adjusted odds ratio [aOR] ​= ​1.88; 95 ​% confidence interval [CI]: 1.46–2.43), higher total hospital costs (144.56 thousand USD; 95 ​% CI: 140.66–148.47), and increased risks of postoperative complications (aOR ​= ​1.59; 95 ​% CI: 1.24–2.05), including tracheostomy, respiratory failure, and pneumonia.

Frailty increases the risk of adverse outcomes after SSRF, highlighting the importance of incorporating frailty assessment into perioperative care.