Evidence map›Paper›PMID 31115615›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

Smoking is associated with an improved short-term outcome in patients with rib fractures.

Areg Grigorian, Michael Lekawa, Matthew Dolich, Sebastian D Schubl, Andrew R Doben, Catherine M Kuza, Cristobal Barrios, Jeffry Nahmias

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Left subclavian artery coverage during endovascular repair of thoracic aorta injury in trauma and non-trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Review
  5. Article
  6. Smoking status and outcomes in patients with rib fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Areg GrigorianDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA. agrigori@uci.edu.ORCID http://orcid.org/0000-0002-0998-796X
Michael LekawaDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Matthew DolichDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Sebastian D SchublDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Andrew R DobenDepartment of Surgery, Baystate Medical Center Affiliate of Tufts University School of Medicine, Springfield, MA, USA.
Catherine M KuzaDepartment of Anesthesiology, University of Southern California, Los Angeles, CA, USA.
Cristobal BarriosDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Jeffry NahmiasDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, Irvine Medical Center, University of California, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
University of California, Irvine Medical Center · USTufts University · USUniversity of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSmokers with cardiovascular disease have been reported to have decreased mortality compared to non-smokers. Rib fractures are associated with significant underlying injuries such as lung contusions, lacerations, and/or pneumothoraces. We hypothesized that blunt trauma patients with rib fractures who are smokers have decreased ventilator days and risk of in-hospital mortality compared to non-smokers. STUDY

designThe Trauma Quality Improvement Program (2010-2016) was queried for patients presenting with a blunt rib fracture. Patients that died within 24 h of admission were excluded. A multivariable logistic regression model was performed.

resultsFrom 282,986 patients with rib fractures, 57,619 (20.4%) were smokers. Compared to non-smokers with rib fractures, smokers had a higher median injury severity score (17 vs. 16, p < 0.001). Smokers had a higher rate of pneumonia (7.5% vs. 6.6%, p < 0.001), however, less ventilator days (5 vs. 6, p = 0.04), and lower in-hospital mortality rate (2.3% vs. 4.6%, p < 0.001), compared to non-smokers. After controlling for covariates, smokers with rib fractures were associated with a decreased risk for in-hospital mortality compared to non-smokers with rib fractures (OR 0.64, 0.56-0.73, p < 0.001).

conclusionDespite having more severe injuries and increased rates of pneumonia, smokers with rib fractures were associated with nearly a 40% decreased risk of in-hospital mortality and one less ventilator day compared to non-smokers. The long-term detrimental effects of smoking have been widely established. However, the biologic and pathophysiologic adaptations that smokers have may confer a survival benefit when recovering in the hospital from chest wall trauma. This study was limited by the database missing the number of pack-years smoked. Future prospective studies are needed to confirm this association and elucidate the physiologic mechanisms that may explain these findings.

Indexed as

SmokingAdultAgedCaliforniaFemaleHospital MortalityHumansInjury Severity ScoreMaleMiddle AgedPneumoniaRespiration, ArtificialRetrospective StudiesRib FracturesRisk FactorsWounds, NonpenetratingMortalityNicotinePneumoniaSmokingTrauma

Identifiers

PMID31115615
OpenAlexW2945726259

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.