Effect of surgical stabilization of rib fractures in polytrauma: an analysis of the TraumaRegister DGU


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 2022
Historique:
received: 05 04 2021
accepted: 26 12 2021
pubmed: 5 2 2022
medline: 11 8 2022
entrez: 4 2 2022
Statut: ppublish

Résumé

In severely injured patients with multiple rib fractures the beneficial effect of surgical stabilization is still unknown. The existing literature shows divergent results and especially the indication and the right timing of an operation are subject of a broad discussion. The aim of this study was to determine the influence of a surgical stabilization of rib fractures (SSRF) on the outcome in a multi-center database with special regard to the duration of ventilation, intensive care and overall hospital stay. Data from the TraumaRegister DGU In total 483 patients received an operative treatment and 29,447 were treated conservatively. SSRF was associated with a significantly lower mortality rate (7.6% vs. 3.3%, p = 0.008) but a longer ventilation time and longer stay as well as in the intensive care unit (ICU) as the overall hospital stay. Both matched pair groups showed a good or very good neurological outcome according to the Glasgow Outcome Scale (GOS) in 4 of 5 cases. Contrary to the existing recommendations most of the patients were not operated within 48 h. In our data set, obviously most of the patients were not treated according to the recent literature and showed a delay in the time for operative care of well over 48 h. This may lead to an increased rate of complications and a longer stay at the ICU and the hospital in general. Despite of these findings patients with operative treatment show a significant lower mortality rate.

Identifiants

pubmed: 35118558
doi: 10.1007/s00068-021-01864-0
pii: 10.1007/s00068-021-01864-0
pmc: PMC9360126
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2773-2781

Informations de copyright

© 2022. The Author(s).

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Auteurs

Lars Becker (L)

Department of Trauma Surgery, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany. lars.becker@uk-essen.de.

Stefan Schulz-Drost (S)

Department of Trauma Surgery, Helios Hospital Schwerin, Schwerin, Germany.
Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.

Christopher Spering (C)

Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Hospital Göttingen Medical Center, Göttingen, Germany.

Axel Franke (A)

Department of Trauma Surgery and Orthopaedics, Reconstructive and Hand Surgery, Burn Medicine, German Armed Forces Central Hospital Koblenz, Koblenz, Germany.

Marcel Dudda (M)

Department of Trauma Surgery, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany.

Rolf Lefering (R)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.

Gerrit Matthes (G)

Department of Trauma Surgery and Reconstructive Surgery, Ernst Von Bergmann Hospital, Potsdam, Germany.

Dan Bieler (D)

Department of Trauma Surgery and Orthopaedics, Reconstructive and Hand Surgery, Burn Medicine, German Armed Forces Central Hospital Koblenz, Koblenz, Germany.
Department of Orthopaedics and Trauma Surgery, Heinrich Heine University Hospital, Düsseldorf, Düsseldorf, Germany.

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