WFRF:(Fraser H. J.)
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- Prins, J. T. H. (author)
Surgical stabilization versus nonoperative treatment for flail and non-flail rib fracture patterns in patients with traumatic brain injury
- Article/chapterEnglish2022
Publisher, publication year, extent ...
- 2022-02-22
- Springer Science and Business Media LLC,2022
Numbers
- LIBRIS-ID:oai:gup.ub.gu.se/314171
- https://gup.ub.gu.se/publication/314171URI
- https://doi.org/10.1007/s00068-022-01906-1DOI
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- Language:English
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- SwePubSwePub
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- Purpose Literature 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. Methods A 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. Results In 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). Conclusion In 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.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
- Surgical stabilization of rib fractures
- Rib fracture
- Flail chest
- Traumatic brain injury
- Thoracic trauma
- randomized controlled-trial
- operative management
- chest injuries
- level
- i
- fixation
- mortality
- Emergency Medicine
Added entries (persons, corporate bodies, meetings, titles ...)
- Van Lieshout, E. M. M. (author)
- Ali-Osman, F. (author)
- Bauman, Z. M. (author)
- Caragounis, Eva CorinaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xcarae (author)
- Choi, J. (author)
- Christie, D. B. (author)
- Cole, P. A. (author)
- DeVoe, W. B. (author)
- Doben, A. R. (author)
- Eriksson, E. A. (author)
- Forrester, J. D. (author)
- Fraser, D. R. (author)
- Gontarz, B. (author)
- Hardman, C. (author)
- Hyatt, D. G. (author)
- Kaye, A. J. (author)
- Ko, H. J. (author)
- Leasia, K. N. (author)
- Leon, S. (author)
- Marasco, S. F. (author)
- McNickle, A. G. (author)
- Nowack, T. (author)
- Ogunleye, T. D. (author)
- Priya, P. (author)
- Richman, A. P. (author)
- Schlanser, V. (author)
- Semon, G. R. (author)
- Su, Y. H. (author)
- Verhofstad, M. H. J. (author)
- Whitis, J. (author)
- Pieracci, F. M. (author)
- Wijffels, M. M. E. (author)
- Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi (creator_code:org_t)
Related titles
- In:European Journal of Trauma and Emergency Surgery: Springer Science and Business Media LLC48:4, s. 3327-33381863-99331863-9941
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- Christie, D. B.
- Cole, P. A.
- DeVoe, W. B.
- Doben, A. R.
- Eriksson, E. A.
- Forrester, J. D.
- Fraser, D. R.
- Gontarz, B.
- Hardman, C.
- Hyatt, D. G.
- Kaye, A. J.
- Ko, H. J.
- Leasia, K. N.
- Leon, S.
- Marasco, S. F.
- McNickle, A. G.
- Nowack, T.
- Ogunleye, T. D.
- Priya, P.
- Richman, A. P.
- Schlanser, V.
- Semon, G. R.
- Su, Y. H.
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- Whitis, J.
- Pieracci, F. M.
- Wijffels, M. M. ...
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