ArticleJournal of thoracic disease2026
Clinical value of surgical intervention and decision-making dilemmas for elderly patients of rib fractures: a systematic review and meta-analysis.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
Background: For elderly patients, when weighing the benefits and risks associated with surgery, the treatment strategy remains controversial. Our objective was to compare clinical outcomes between surgical and non-surgical management of rib fractures in patients aged ≥60 years. Methods: PubMed, Embase, Cochrane Library, and Web of Science were searched for studies comparing surgical intervention with non-surgical treatment in elderly patients of rib fractures over the past decade. The mean differences (MDs) for continuous outcomes, the risk ratios (RRs) for binary outcomes, and the 95% confidence intervals (CIs) were calculated. Meta-analysis was performed using Review Manager (RevMan) version 5.4. Results: Ten studies were included with a total of 98,004 patients, of whom 2,478 underwent surgical intervention. Compared with non-surgical treatment, surgical intervention was associated with lower mortality (RR =0.61, 95% CI: 0.49, 0.75, P<0.001), longer hospital stay (MD =5.75, 95% CI: 4.50, 7.01, P<0.001), longer intensive care unit (ICU) stay (MD =2.16, 95% CI: 0.21, 4.11, P=0.03), and lower readmission risk (RR =0.30, 95% CI: 0.11, 0.79, P=0.01). No significant differences were noted in the incidence of pneumonia (RR =1.21, 95% CI: 0.50, 2.92, P=0.67), pleural effusion (RR =0.32, 95% CI: 0.03, 3.60, P=0.36), pneumothorax (RR =0.43, 95% CI: 0.04, 5.15, P=0.51), respiratory failure (RR =1.10, 95% CI: 0.50, 2.43, P=0.81) and duration of mechanical ventilation (DMV) (MD =-0.22, 95% CI: -1.25, 0.81, P=0.68). Subgroup analysis showed no significant difference in mortality among patients aged ≥80 years (RR =0.87, 95% CI: 0.59, 1.29, P=0.49). Conclusions: Elderly patients of rib fractures may benefit from surgical intervention, particularly those aged under 80 years. For super-elderly patients aged ≥80 years, the value of surgical intervention is not obvious. For this population, high-quality prospective studies are needed to further clarify the clinical value of surgery.
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