PMID- 27272917 OWN - NLM STAT- MEDLINE DCOM- 20180425 LR - 20191210 IS - 1863-9941 (Electronic) IS - 1863-9933 (Linking) VI - 43 IP - 4 DP - 2017 Aug TI - Evaluation of efficacy and indications of surgical fixation for multiple rib fractures: a propensity-score matched analysis. PG - 541-547 LID - 10.1007/s00068-016-0687-0 [doi] AB - PURPOSE: The purpose of this study was to assess the effects of recent surgical rib fixation and establish its indications not only for flail chest but also for multiple rib fractures. METHODS: Between 2007 and 2015, 187 patients were diagnosed as having multiple rib fractures in our institution. After the propensity score matching was performed, ten patients who had performed surgical rib fixation and ten patients who had treated with non-operative management were included. Categorical variables were analyzed with Fischer's exact test and non-parametric numerical data were compared using the Mann-Whitney U test. Wilcoxon signed-rank test was performed for comparison of pre- and postoperative variables. All statistical data are presented as median (25-75 % interquartile range [IQR]) or number. RESULTS: The surgically treated patients extubated significantly earlier than non-operative management patients (5.5 [1-8] vs 9 [7-12] days: p = 0.019). The duration of continuous intravenous narcotic agents infusion days (4.5 [3-6] vs 12 [9-14] days: p = 0.002) and the duration of intensive care unit stay (6.5 [3-9] vs 12 [8-14] days: p = 0.008) were also significantly shorter in surgically treated patients. Under the same ventilating conditions, the postoperative values of tidal volume and respiratory rate improved significantly compared to those values measured just before the surgery. The incidence of pneumonia as a complication was significantly higher in non-operative management group (p = 0.05). CONCLUSIONS: From the viewpoints of early respiratory stabilization and intensive care unit disposition without any complications, surgical rib fixation is a sufficiently acceptable procedure not only for flail chest but also for repair of severe multiple rib fractures. FAU - Uchida, K AU - Uchida K AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. cvs.uchida@gmail.com. FAU - Nishimura, T AU - Nishimura T AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Takesada, H AU - Takesada H AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Morioka, T AU - Morioka T AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Hagawa, N AU - Hagawa N AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Yamamoto, T AU - Yamamoto T AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Kaga, S AU - Kaga S AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Terada, T AU - Terada T AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Shinyama, N AU - Shinyama N AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Yamamoto, H AU - Yamamoto H AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. FAU - Mizobata, Y AU - Mizobata Y AD - Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan. LA - eng PT - Evaluation Study PT - Journal Article DEP - 20160606 PL - Germany TA - Eur J Trauma Emerg Surg JT - European journal of trauma and emergency surgery : official publication of the European Trauma Society JID - 101313350 SB - IM MH - Adolescent MH - Adult MH - Aged MH - *Decision Support Techniques MH - Female MH - Flail Chest/surgery MH - Fractures, Multiple/diagnostic imaging/pathology/*surgery MH - Humans MH - *Injury Severity Score MH - Japan MH - Male MH - Middle Aged MH - Minimally Invasive Surgical Procedures/methods MH - Predictive Value of Tests MH - *Propensity Score MH - Retrospective Studies MH - Rib Fractures/diagnostic imaging/pathology/*surgery MH - Young Adult OTO - NOTNLM OT - Flail chest OT - Multiple rib fractures OT - Non-operative management OT - Operative result OT - Surgical rib fixation EDAT- 2016/06/09 06:00 MHDA- 2018/04/26 06:00 CRDT- 2016/06/09 06:00 PHST- 2016/03/23 00:00 [received] PHST- 2016/05/28 00:00 [accepted] PHST- 2016/06/09 06:00 [pubmed] PHST- 2018/04/26 06:00 [medline] PHST- 2016/06/09 06:00 [entrez] AID - 10.1007/s00068-016-0687-0 [pii] AID - 10.1007/s00068-016-0687-0 [doi] PST - ppublish SO - Eur J Trauma Emerg Surg. 2017 Aug;43(4):541-547. doi: 10.1007/s00068-016-0687-0. Epub 2016 Jun 6.