Evidence map›Paper›PMID 35192003›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

Surgical stabilization versus nonoperative treatment for flail and non-flail rib fracture patterns in patients with traumatic brain injury.

Jonne T H Prins, Esther M M Van Lieshout, Francis Ali-Osman, Zachary M Bauman, Eva-Corina Caragounis, Jeff Choi, D Benjamin Christie, Peter A Cole, William B DeVoe, Andrew R Doben and 23 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
5.9field-weighted citation impact, top 3% 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

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Guideline
  2. Article
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  5. Review
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  8. Review
  9. Article
  10. Application of Titanium Mesh in the Early Treatment of Flail Chest.International journal of biomaterials · 2024
    Article
  11. Article
  12. Chest wall stabilization in a patient with severe TBI: A case report.International journal of surgery case reports · 2023
    Article
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors at 20 institutions in 5 countries.

Jonne T H PrinsTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Esther M M Van LieshoutTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Francis Ali-OsmanDepartment of Surgery, HonorHealth John C. Lincoln Medical Center, Phoenix, AZ, 85020, USA.
Zachary M BaumanDivision of Trauma, Emergency General Surgery, Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Eva-Corina CaragounisDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Jeff ChoiSection of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, CA, 94305, USA.
D Benjamin ChristieDepartment of Trauma Surgery/Critical Care, Mercer University School of Medicine, The Medical Center Navicent Health, Macon, GA, 31201, USA.
Peter A ColeHealthPartners Orthopedics and Sports Medicine, Bloomington, MN, 55420, USA.
William B DeVoeDepartment of Surgery, Riverside Methodist Hospital, Columbus, 43214 OH, USA.
Andrew R DobenDepartment of Surgery, Saint Francis Hospital, Hartford, CT, 06105, USA.
Evert A ErikssonDivision of Trauma and Critical Care, Department of Surgery, Medical University of South Carolina, Charleston, SC, 29425, USA.
Joseph D ForresterSection of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, CA, 94305, USA.
Douglas R FraserDepartment of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, 89102, USA.
Brendan GontarzDepartment of Surgery, Saint Francis Hospital, Hartford, CT, 06105, USA.
Claire HardmanDivision of Trauma, Department of Surgery, Wright State University/Miami Valley Hospital, Dayton, OH, 45409, USA.
Daniel G HyattDepartment of Surgery, Riverside Methodist Hospital, Columbus, 43214 OH, USA.
Adam J KayeDepartment of Surgery, Overland Park Regional Medical Center, Overland Park, KS, 66215, USA.
Huan-Jang KoDivision of Trauma Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, 30059, Taiwan.
Kiara N LeasiaDepartment of Surgery, Denver Health Medical Center, Denver, CO, 80204, USA.
Stuart LeonDivision of Trauma and Critical Care, Department of Surgery, Medical University of South Carolina, Charleston, SC, 29425, USA.
Silvana F MarascoCJOB Department of Cardiothoracic Surgery, The Alfred, Melbourne, Australia.
Allison G McNickleDepartment of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, 89102, USA.
Timothy NowackDepartment of Trauma Surgery/Critical Care, Mercer University School of Medicine, The Medical Center Navicent Health, Macon, GA, 31201, USA.
Temi D OgunleyeDepartment of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, 55455, USA.
Prakash PriyaDepartment of Surgery, Overland Park Regional Medical Center, Overland Park, KS, 66215, USA.
Aaron P RichmanDepartment of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Victoria SchlanserDepartment of Trauma/Burn, John H Stroger Hospital of Cook County, Chicago, IL, 60612, USA.
Gregory R SemonDivision of Trauma, Department of Surgery, Wright State University/Miami Valley Hospital, Dayton, OH, 45409, USA.
Ying-Hao SuDivision of Trauma Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, 30059, Taiwan.
Michael H J VerhofstadTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Julie WhitisDepartment of Surgery, University of Texas Rio Grande Valley, Doctors Hospital at Renaissance, Edinburg, TX, 78539, USA.
Fredric M PieracciDepartment of Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO, 80204, USA.
Mathieu M E WijffelsTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. m.wijffels@erasmusmc.nl.
Erasmus MC · NLMedical University of South Carolina · USMiami Valley Hospital · USNational Taiwan University Hospital · TWRegional Medical Center · USRegions Hospital · USRiverside Methodist Hospital · USStanford University · USUniversity of Nevada, Las Vegas · USBoston Medical Center · USDenver Health Medical Center · USDoctors Hospital at Renaissance · USJohn H. Stroger, Jr. Hospital of Cook County · USLincoln Medical Center · USMercer University · USMonash University · AUNavicent Health · USSaint Francis Hospital · USSaint Francis University · USUniversity of Colorado Denver · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLiterature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients.

methodsA post hoc subgroup analysis of the multicenter, retrospective CWIS-TBI study was performed in patients with TBI and stratified by having sustained a non-flail fracture pattern or flail chest between January 1, 2012 and July 31, 2019. The primary outcome was mechanical ventilation-free days and secondary outcomes were in-hospital outcomes. In multivariable analysis, outcomes were assessed, stratified for rib fracture pattern.

resultsIn total, 449 patients were analyzed. In patients with a non-flail fracture pattern, 25 of 228 (11.0%) underwent SSRF and in patients with a flail chest, 86 of 221 (38.9%). In multivariable analysis, ventilator-free days were similar in both treatment groups. For patients with a non-flail fracture pattern, the odds of pneumonia were significantly lower after SSRF (odds ratio 0.29; 95% CI 0.11-0.77; p = 0.013). In patients with a flail chest, the ICU LOS was significantly shorter in the SSRF group (beta, - 2.96 days; 95% CI - 5.70 to - 0.23; p = 0.034).

conclusionIn patients with TBI and a non-flail fracture pattern, SSRF was associated with a reduced pneumonia risk. In patients with TBI and a flail chest, a shorter ICU LOS was observed in the SSRF group. In both groups, SSRF was safe and did not hamper neurological recovery.

Indexed as

Brain Injuries, TraumaticFlail ChestPneumoniaRib FracturesFracture Fixation, InternalHumansLength of StayRetrospective StudiesFlail chestRib fractureSurgical stabilization of rib fracturesThoracic traumaTraumatic brain injury

Identifiers

PMID35192003
PMCPMC9360098
OpenAlexW4213331043

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.