Evidence map›Paper›PMID 42635804›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026

Surgical stabilization of rib fractures is associated with lower adjusted odds of adverse pulmonary outcomes across RibScore-defined injury severity: a single-center cohort study.

Vladislav Muldiiarov, John L Liu, Ashley Campbell, Sophie Bouldoukian, Allie Daro, Sarah E Kemp, Mike Matos, Emily Cantrell, John Tierney, W T Hillman Terzian and 2 more

Abstract read
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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 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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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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

12 authors.

Vladislav MuldiiarovNorton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
John L LiuDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Ashley CampbellDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Sophie BouldoukianDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Allie DaroDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Sarah E KempDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Mike MatosDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Emily CantrellDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
John TierneyDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
W T Hillman TerzianDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Narong KulvatunyouDivision of Trauma and Acute Care Surgery, University of Arizona School of Medicine - Phoenix, Phoenix, AZ, USA.
Zachary M BaumanDivision of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA. zachary.bauman@unmc.edu.ORCID http://orcid.org/0000-0001-9409-2193

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical stabilization of rib fractures (SSRF) is increasingly used for selected patients with severe chest wall injury, but its relationship with pulmonary outcomes after accounting for RibScore-defined injury severity remains unclear. This study evaluated adverse pulmonary outcomes after SSRF versus nonoperative management (NONOP) among adults with traumatic rib fractures.

methodsSingle-center retrospective cohort study at an ACS-verified Level I trauma center from January 2016 to April 2023. Adults with CT-confirmed blunt traumatic rib fractures were categorized as SSRF or nonoperative management. RibScore was calculated from initial CT imaging. The primary outcome was a composite of pneumonia, invasive mechanical ventilation for more than 48 h, or tracheostomy. Multivariable logistic regression adjusted for demographics, RibScore, thoracic and extra-thoracic injury severity, calendar year, COPD, and current smoking status.

resultsAmong 3,066 patients, 444 underwent SSRF and 2,622 were managed nonoperatively. SSRF patients had greater radiographic chest wall injury severity, including a higher median RibScore than NONOP patients (2 vs. 0; p < 0.001). Composite adverse pulmonary outcome occurred in 14.6% of SSRF patients and 16.6% of NONOP patients. In adjusted analysis, SSRF was associated with lower odds of composite adverse pulmonary outcome (aOR 0.57, 95% CI 0.40-0.81; p = 0.002) and respiratory failure (aOR 0.57, 95% CI 0.39-0.83; p = 0.004).

conclusionsDespite greater radiographic chest wall injury severity, SSRF was associated with lower adjusted odds of composite adverse pulmonary outcome and respiratory failure compared with nonoperative management after accounting for RibScore and other injury severity measures.

Indexed as

Fracture FixationRib FracturesWounds, NonpenetratingAdultAgedFemaleHumansInjury Severity ScoreMaleMiddle AgedPneumoniaRespiration, ArtificialRetrospective StudiesTomography, X-Ray ComputedTrauma CentersPulmonary complicationsRespiratory failureRib fracturesRibScoreSurgical stabilization of rib fracturesTrauma surgery

Identifiers

PMID42635804

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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.