A multicenter evaluation of the optimal timing of surgical stabilization of rib fractures

The Journal of Trauma and Acute Care Surgery
Fredric M PieracciAndrew R Doben

Abstract

The optimal timing of surgical stabilization of rib fractures (SSRF) remains debated. We hypothesized that (1) demographic, radiologic, and clinical variables are associated with time to surgery and (2) shorter time to SSRF improves acute outcomes. Prospectively collected SSRF databases from four trauma centers were merged and analyzed (2006-2016). The independent variable was days from hospital admission to SSRF (early [<1 day], mid [1-2 days], and late [3-10 days]). Outcomes included length of operation, number of ribs repaired, prolonged (>24 hours) mechanical ventilation, pneumonia, tracheostomy, length of stay, and mortality. Multivariable logistic regression was used to control for significant differences in covariates between groups. Five hundred fifty-one patients were analyzed. The median time to SSRF was 1 day (range, 0-10); 207 (37.6%) patients were in the early group, 168 (30.5%) in the midgroup, and 186 (31.9%) in the late group. There was a significant shift toward earlier SSRF over the study period. Time to SSRF was significantly associated with study center (p < 0.01), year of surgery (p < 0.01), age (p = 0.02), mechanism of injury (p = 0.04), and body mass index (p = 0.02). Injury severity was not associated wi...Continue Reading

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Citations

May 23, 2018·The Journal of Trauma and Acute Care Surgery·Stefano MagnoneMichele Pisano
Sep 11, 2018·Critical Care Medicine·Samuel A Tisherman, Deborah M Stein
Oct 31, 2018·The Journal of Trauma and Acute Care Surgery·Fredric M Pieracci
Jan 7, 2020·Trauma Surgery & Acute Care Open·Jose J Diaz, Faris K Azar
Jul 12, 2020·Journal of Cardiac Surgery·Sung Kwang LeeChee Hoon Lee
Apr 30, 2020·The Journal of Trauma and Acute Care Surgery·Fredric M Pieracci, Adam Shiroff
Aug 6, 2020·Interactive Cardiovascular and Thoracic Surgery·Oliver ClaydonElizabeth Belcher
Aug 26, 2020·The American Surgeon·Kevin N HarrellRobert A Maxwell
May 23, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Mathieu M E WijffelsMichael H J Verhofstad
Oct 3, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Reinier B BeksRoderick M Houwert
Sep 19, 2020·JBJS Essential Surgical Techniques·Alexander A FokinIvan Puente
Sep 20, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Reinier B BeksLuke P H Leenen
Nov 22, 2018·The Journal of Trauma and Acute Care Surgery·Fredric M PieracciAndrew R Doben
Mar 17, 2020·The Journal of Trauma and Acute Care Surgery·Roger Chen ZhuKonstantin Khariton
May 22, 2020·Current Anesthesiology Reports·Michelle Kim, James E Moore
Oct 6, 2020·The Journal of Trauma and Acute Care Surgery·Ashton B ChristianSebastian D Schubl
Dec 9, 2020·Operative Orthopädie und Traumatologie·Christopher SperingKlaus Dresing
Jul 8, 2020·The Thoracic and Cardiovascular Surgeon·Hüseyin Ulaş Çınar, Burçin Çelik
Nov 20, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Shunichi OtakaHideo Yasunaga
May 4, 2020·The Annals of Thoracic Surgery·Shunichi OtakaHideo Yasunaga
Feb 10, 2021·The Journal of Trauma and Acute Care Surgery·Jeff ChoiJoseph D Forrester
Feb 23, 2021·American Journal of Surgery·Jeff ChoiJoseph D Forrester
Feb 20, 2021·The Journal of Surgical Research·Eric O YeatesSebastian D Schubl
May 22, 2021·The Journal of Trauma and Acute Care Surgery·Fredric M PieracciAndrew R Doben
Jun 1, 2021·The Journal of Surgical Research·Alexandra C FerreVanessa P Ho
Aug 31, 2021·Trauma Case Reports·Jin WuWilliam DeVoe
Jul 3, 2021·The Annals of Thoracic Surgery·Natthida OwattanapanichDemetrios Demetriades
Oct 12, 2021·The Journal of Trauma and Acute Care Surgery·William B DeVoeEvert A Eriksson

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