Flail chest injuries

Dehghan, Niloofar; Mestral, Charles de; McKee, Michael D.; Schemitsch, Emil H.; Nathens, Avery B.

doi:10.1097/ta.0000000000000086

Cited by 293 publications

(120 citation statements)

References 20 publications

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“…Blunt chest trauma such as rib fractures, lung contusion, pneumothorax, and hemothorax have been frequently associated with extrathoracic injuries on the head, the abdomen, and the extremities 1, 8, 14, 15, 18, 19, 20. Of these injuries, it is reported that the four variables, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Of these injuries, it is reported that the four variables, i.e. flail chest, lung contusion, the number of rib fractures, and severe head injury, may cause PMV 8, 14…”

Section: Discussionmentioning

confidence: 99%

“…Flail chest injury may be life‐threatening resulting from deformity of the chest wall and volume loss of the lung 8, 21, 22, 23. This severe injury of the chest wall may be demonstrated by inefficient breathing and respiratory suppression caused by chest pain and/or overdose of analgesics.…”

Section: Discussionmentioning

confidence: 99%

“…Dehghan et al . reported that 59% of flail chest patients needed ventilatory support 8. Huber et al .…”

Section: Discussionmentioning

confidence: 99%

“…In multiple trauma patients, lung contusion, flail chest, and severe head injury are possible significant risk factors for mechanical ventilatory support 8, 9, 10, 11, 12, 13, 14. However, to our knowledge, there have been no established risk factors for prolonged mechanical ventilation (PMV) in patients with blunt chest trauma.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Okabe¹

2018

Acute Medicine & Surgery

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AimBlunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV).MethodsConsecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart‐review study. According to ventilatory time, the patients were divided into PMV (≥7 days) and shortened mechanical ventilation (SMV; <7 days) groups. Thoracic Trauma Severity Score (TTSS) was calculated. To identify risk factors for PMV, univariate and multivariate logistic analyses and receiver operating characteristic analysis were carried out.ResultsEighty‐four and 49 patients were assigned to PMV and SMV groups, respectively. Compared with the SMV group, the PMV group had a significantly larger number of fractured ribs (P < 0.01), higher rate of severe Glasgow Coma Scale (GCS ≤8) (P < 0.05) and flail chest (P < 0.001), higher TTSS (P < 0.001), or longer intensive care unit and hospital stay (both P < 0.001). Logistic analysis showed that severe GCS (odds ratio [OR] = 4.6, P < 0.01), flail chest (OR = 3.0, P < 0.05), and TTSS (OR = 1.2; P < 0.01) were independent significant risk factors. Receiver operating characteristic analyses showed that the area under the curves for TTSS, flail chest, and severe GCS were 0.74, 0.70, and 0.58, respectively. When the three factors were combined, the area under the curve increased to 0.8.ConclusionSevere GCS (≤8), flail chest, or TTSS may be independent risk factors. Combining the three risk factors could provide high predictive performance for PMV.

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Section: Discussionmentioning

confidence: 99%

“…Of these injuries, it is reported that the four variables, i.e. flail chest, lung contusion, the number of rib fractures, and severe head injury, may cause PMV 8, 14…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Dehghan et al . reported that 59% of flail chest patients needed ventilatory support 8. Huber et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Okabe¹

2018

Acute Medicine & Surgery

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Association Between Adherence to Evidence-Based Practices for Treatment of Patients With Traumatic Rib Fractures and Mortality Rates Among US Trauma Centers

et al. 2020

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IMPORTANCE Rib fractures are sustained by nearly 15% of patients who experience trauma and are associated with significant morbidity and mortality. Evidence-based practice (EBP) rib fracture management guidelines and treatment algorithms have been published. However, few studies have evaluated trauma center adherence to EBP or the clinical outcomes of each practice within a national cohort. OBJECTIVE To examine adherence to 6 EBPs for rib fractures across US trauma centers and the association with in-hospital mortality.

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