Fixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis.
Aged
Conservative Treatment
/ methods
Critical Care
/ statistics & numerical data
Female
Flail Chest
/ mortality
Fracture Fixation
/ methods
Humans
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Observational Studies as Topic
Pneumonia
/ etiology
Randomized Controlled Trials as Topic
Respiration, Artificial
/ mortality
Rib Fractures
/ mortality
Tracheostomy
/ mortality
Current evidence
Flail chest
Multiple rib fractures
Nonoperative treatment
Operative treatment
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
19
06
2018
accepted:
24
09
2018
pubmed:
3
10
2018
medline:
6
2
2020
entrez:
3
10
2018
Statut:
ppublish
Résumé
The aim of this systematic review and meta-analysis was to present current evidence on rib fixation and to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies. MEDLINE, Embase, CENTRAL, and CINAHL were searched on June 16th 2017 for both RCTs and observational studies comparing rib fixation versus nonoperative treatment. The MINORS criteria were used to assess study quality. Where possible, data were pooled using random effects meta-analysis. The primary outcome measure was mortality. Secondary outcome measures were hospital length of stay (HLOS), intensive care unit length of stay (ILOS), duration of mechanical ventilation (DMV), pneumonia, and tracheostomy. Thirty-three studies were included resulting in 5874 patients with flail chest or multiple rib fractures: 1255 received rib fixation and 4619 nonoperative treatment. Rib fixation for flail chest reduced mortality compared to nonoperative treatment with a risk ratio of 0.41 (95% CI 0.27, 0.61, p < 0.001, I Rib fixation for flail chest improves short-term outcome, although the indication and patient subgroup who would benefit most remain unclear. There is insufficient data regarding treatment for multiple rib fractures. Observational studies show similar results compared with RCTs.
Identifiants
pubmed: 30276722
doi: 10.1007/s00068-018-1020-x
pii: 10.1007/s00068-018-1020-x
pmc: PMC6689030
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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