Evidence map›Paper›PMID 40232329›Full record

Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Thoracostomy for removal of excess fluid in surgical stabilization of rib fractures: the T-REX trial.

Sarah Majercik, Scott Gardner, Evert A Eriksson, Joseph D Forrester, Joshua A Villarreal, Zachary M Bauman, Lindsey Cavlovic, Andrew R Doben, Gregory R Semon, Fredric M Pieracci and 6 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

16 authors.

Sarah MajercikDivision of Trauma Services and Surgical Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, Salt Lake City, UT, 84157, USA. Sarah.Majercik@imail.org.
Scott GardnerDivision of Trauma Services, Intermountain Medical Center, Murray, UT, USA.
Evert A ErikssonMedical University of South Carolina, Charleston, USA.
Joseph D ForresterDepartment of Surgery, Stanford University, Stanford Health Care, Stanford, USA.
Joshua A VillarrealDepartment of Surgery, Stanford University, Stanford Health Care, Stanford, USA.
Zachary M BaumanTrauma, Surgical Critical Care, Emergency General Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, USA.
Lindsey CavlovicCollege of Osteopathic Medicine, KCU, Kansas City, USA.
Andrew R DobenDivision of Acute Care Surgery, Trauma Surgery, and Surgical Critical Care, Saint Francis Hospital and Medical Center, University of Connecticut School of Medicine, Frank H. Netter MD School of Medicine Quinnipiac University, Roslyn, USA.
Gregory R SemonDepartment of Surgery, Division of Trauma/Acute Care Surgery, Surgical Intensive Care Unit, Wright State University Boonshoft School of Medicine, Miami Valley Hospital, Injury Prevention Center of Greater Dayton, Dayton, USA.
Fredric M PieracciDenver Health Medical Center, University of Colorado, SOM, Denver, USA.
Theresa MorinCenter for Health Systems Research, Denver Health, Denver, USA.
Kelley MancineResearch Operations, Office of Research, Denver Health, Denver, USA.
Zachary D WarrinerGeneral Surgery Acute Care Surgery, Trauma and Surgical Critical Care, University of Kentucky Chandler Medical Center, Lexington, USA.
Caroline NeffDenver Health Medical Center, University of Colorado, SOM, Denver, USA.
SarahAnn S WhitbeckChest Wall Injury Society, Salt Lake City, USA. sarahann@cwisociety.org.
Thomas W WhiteDivision of Trauma Services and Surgical Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, Salt Lake City, UT, 84157, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManagement of the pleural space during and after SSRF is a matter of debate. Tube thoracostomy (TT), intra-operative pleural lavage (PL) and video assisted thoracoscopic surgery (VATS) use varies between surgeons. The purpose of this study is to describe differences in practice patterns of pleural space management (TT, PL, VATS) after SSRF at institutions with extensive experience in chest wall reconstruction.

methodsProspective data from adult SSRF patients at eight U.S. trauma centers between January 1, 2020 and September 1, 2022 was collected. Patients were managed according to institutional protocols. Outcome measures included hospital and ICU length of stay, 30-day readmission rate, infectious complications, and incidence of procedural re-intervention. Discrete variables are reported as median (IQR). P-values for continuous variables were obtained using Kruskal-Wallis, and for categorical variables using Chi-square.

results273 patients from 8 centers were included. Median age was 60 (46-68), 70% were male, and 99% suffered blunt trauma. ISS was 17 (13-26), ranging from a low of 14 (10-19) to 26 (18-35) (p = 0.002). Median operative time was 2.5 (1.9-3.3) hours, with 5 (4-6) plates placed. VATS ranged from 2 to 78% at each center and PL ranged from 25 to 100% (p < 0.001). Almost all patients received TT. TT remained in place for 3 (2-4) days, few (2%) had any complication related to the TT, nor did they require drain replacement (7%) or reoperation (2%). ICU and hospital lengths of stay were 3 (2-6) and 8 (6-13) days (P < 0.001). Readmission rates were low (4%), and did not differ between centers.

conclusionAt centers experienced in SSRF, there is variation in management of the pleural space. While ICU and hospital lengths of stay are different between centers, rates of reoperation and readmission are similar. Further study is needed to delineate optimal management of the pleural space after SSRF.

Indexed as

Rib FracturesThoracostomyAgedChest TubesFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionProspective StudiesReoperationTherapeutic IrrigationThoracic Surgery, Video-AssistedTrauma CentersPleural space managementSSRFSurgical stabilization of rib fracturesThoracic trauma

Identifiers

PMID40232329

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.