Evidence map›Paper›PMID 36151336›Full record

ArticleWorld journal of surgery2022

Surgical Rib Fixation in Obese Patients with Isolated Flail Chest Improves Outcomes: A Matched Cohort Study.

Joshua Dilday, Chih Ying Chien, Meghan Lewis, Brent Emigh, Elizabeth R Benjamin, Demetrios Demetriades

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Surgical rib fixation in patients with cardiopulmonary disease improves outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  3. Biomechanics of flail chest injuries: tidal volume and respiratory work changes in multiple segmental rib fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  4. Review
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

6 authors at 3 institutions in 2 countries.

Joshua DildayDivision of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051, Marengo St, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Chih Ying ChienDivision of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051, Marengo St, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Meghan LewisDivision of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051, Marengo St, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Brent EmighDivision of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051, Marengo St, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Elizabeth R BenjaminDivision of Trauma and Surgical Critical Care, Grady Memorial Hospital, Atlanta, Georgia.
Demetrios DemetriadesDivision of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051, Marengo St, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA. demetria@usc.edu.
University of Southern California · USGrady Memorial Hospital · USLAC+USC Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is associated with adverse outcomes after major operations. The role of operative rib fixation (RF) in obese patients with flail chest is not clear. The presence of other associated injuries may complicate the interpretation of outcomes. This study compared outcomes after RF to nonoperative management (NOM) in obese patients with isolated flail chest injury.

methodsAdult obese patients (BMI > 29.9) with flail chest were identified from the Trauma Quality Improvement Program (TQIP) database (2016-2018). Hospital transfers, death within 72 h, and extrathoracic injuries were excluded. RF patients were propensity score matched (1:2) to similar NOM patients. Multivariate regression identified independent factors predicting adverse outcomes.

resultsOverall, 367 patients with isolated flail chest who underwent RF were matched with 734 in the NOM group. After matching, the mortality rate was significantly lower in the RF group (1.4% vs. 3.7%; p < 0.05). RF had longer HLOS (15.7 days vs. 12.8 days; p < 0.05) and ICU LOS (10.1 days vs. 8.6 days; p < 0.05), shorter ventilator days (9.2 days vs. 11.5 days; p < 0.05), and a higher rate of venous thromboembolism (7.1% vs. 3.5%, p < 0.05). On multivariate analysis, RF was associated with decreased mortality (OR 0.27; p < 0.05). Early RF (≤ 72 h) was associated with shorter ICU stay and mechanical ventilation.

conclusionRF for isolated flail chest in obese patients is associated with decreased mortality and fewer ventilator days. When performed early, fixation decreases the need for prolonged ventilator use and ICU stay. A more aggressive VTE prophylaxis should be considered in patients undergoing RF.

Indexed as

Flail ChestRib FracturesAdultCohort StudiesHumansLength of StayObesityRetrospective StudiesRibs

Identifiers

PMID36151336
OpenAlexW4297036162

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.