A Randomized Controlled Trial of Surgical Rib Fixation in Polytrauma Patients With Flail Chest

Liu, Tao; Liu, Peng; Chen, Jiajun; Xie, Jie; Yang, Fan; Liao, Yicheng

doi:10.1016/j.jss.2019.04.005

Cited by 71 publications

(61 citation statements)

References 27 publications

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“…[8][9][10][11][12][13][14][15][16] Conventional frequentist meta-analysis may be suboptimal because few randomized controlled trials (RCTs) have compared SSRF with nonoperative management. [17][18][19][20][21] Bayesian meta-analysis has distinct advantages over conventional meta-analysis for comparing SSRF with nonoperative management: it allows intuitive interpretation (eg, there is an x% probability that SSRF is associated with lower mortality than non-operative management); it incorporates inherent bias of observational evidence rather than equally pooling observational and RCT evidence, and it accurately presents uncertainty of pooled effect estimates. [22][23][24] We consolidated up-to-date evidence comparing SSRF and non-operative management effects on pulmonary complications and mortality after rib fractures using Bayesian meta-analysis.…”

mentioning

confidence: 99%

Surgical Stabilization of Rib Fracture to Mitigate Pulmonary Complication and Mortality: A Systematic Review and Bayesian Meta-Analysis

Choi

Gomez

Kaghazchi

et al. 2021

Journal of the American College of Surgeons

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confidence: 99%

Surgical Stabilization of Rib Fracture to Mitigate Pulmonary Complication and Mortality: A Systematic Review and Bayesian Meta-Analysis

Choi

Gomez

Kaghazchi

et al. 2021

Journal of the American College of Surgeons

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“…704 papers were retrieved in total, in which 83 papers were selected after excluding 621 papers that were identical and not in line with this study through reading the title and the abstract. After reading the whole article, 78 papers that did not meet the inclusion criteria were excluded and 5 papers were included finally [16][17][18][19][20]. The retrieval process is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The basic features of the articles 5 included are shown in Table 1. [16][17][18][19][20] were included to analyze the respiratory support time (day). The heterogeneity among these 5 studies was observed (I 2 = 94.6%, P = 0.000 < 0.1), so the random effect model was adopted for Meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

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Meta-Analysis on Comparison of Therapeutic Effects of Different Treatment Methods on Multiple Rib Fractures

Zhang¹,

Feng²,

Pei³

2020

Preprint

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Objective The treatment of multiple rib fractures is worthy of consideration. A Meta-analysis on the surgical and conservative treatment of multiple rib fractures was carried out in this paper to explore the curative effect of these methods and provide some medical evidence. Methods Articles about randomized controlled trials (RCT) on the surgical and conservative treatment of multiple rib fractures were retrieved from the PubMed, Embase and Cochrane library databases, and were screened then to extract the data. The results were displayed by forest plots. Results This study included 5 articles and 337 cases which were divided into the surgical group (161 cases) and conservative group (176 cases). The Meta-analysis showed that differences between the two groups in respirator support time, intensive care unit (ICU) stay time, length of stay, and the incidence of pulmonary infection, chest wall deformity, chest tightness and breathlessness on exertion were statistically significant, and the differences between the two groups in the rate of tracheotomy and in-hospital mortality were not statistically significant. Conclusion The surgical treatment of multiple rib fractures can shorten the respirator support time, ICU stay time and length of stay, and reduce the incidence of pulmonary infection and chest disability, but this should be verified further by more randomized controlled trials. Key words: rib fractures; flail chest; surgical intervention; conservative treatment; Meta-analysis

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“…The mechanisms through which rib fractures cause pneumonia are generally explained by pain [28], decreased vital capacity [29], and changes in chest wall dynamics that distort the movement of chest wall muscle [30]. The frequency of pneumonia increases with the number of rib fractures, particularly in elderly patients [26] and those with frail chest injuries [27].…”

Section: Discussionmentioning

confidence: 99%

Association of Multiple Rib Fractures With Pneumonia After Successful Cardiopulmonary Resuscitation: A Retrospective Cohort Study Using Propensity Score Matching

Kawai

Takano

Miyazaki

et al. 2020

Preprint

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Background: Few studies have examined the impact of chest wall injury on respiratory complications after cardiopulmonary resuscitation. This is due to many confounding factors for the development of complications after cardiopulmonary resuscitation. Accordingly, we investigated the association between multiple rib fractures and the incidence of pneumonia during the post-resuscitation period after adjusting for confounding factors using a propensity score.Methods: This single-centre, retrospective cohort study enrolled adult, non-traumatic, out-of-hospital, cardiac arrest patients who maintained circulation for >48 h between June 2015 and May 2019. Rib fractures were evaluated by computed tomography on the day of hospital admission, and the association with newly developed pneumonia within 7 days of hospitalisation was analysed using propensity score matching with adjustment for variables previously reported to be risk factors for the development of pneumonia.Results: Of the 683 out-of-hospital cardiac arrest patients treated during the study period, 87 eligible cases were enrolled for analysis. Thirty-two patients had multiple rib fractures identified by computed tomography and 35 patients developed pneumonia. The presence of multiple rib fractures was significantly associated with a higher incidence of pneumonia (propensity score-adjusted hazard ratio: 3.51; 95% confidence interval: 1.59–7.72; p=0.002). Consistently, after propensity score matching, the multiple rib fracture group showed significantly shorter pneumonia-free survival than the non-multiple rib fracture group (p<0.01).Conclusion: Multiple rib fractures are independently associated with the development of pneumonia after successful resuscitation.

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A Randomized Controlled Trial of Surgical Rib Fixation in Polytrauma Patients With Flail Chest

Cited by 71 publications

References 27 publications

Surgical Stabilization of Rib Fracture to Mitigate Pulmonary Complication and Mortality: A Systematic Review and Bayesian Meta-Analysis

Surgical Stabilization of Rib Fracture to Mitigate Pulmonary Complication and Mortality: A Systematic Review and Bayesian Meta-Analysis

Meta-Analysis on Comparison of Therapeutic Effects of Different Treatment Methods on Multiple Rib Fractures

Association of Multiple Rib Fractures With Pneumonia After Successful Cardiopulmonary Resuscitation: A Retrospective Cohort Study Using Propensity Score Matching

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