Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest
Abstract Background Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Traum...
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| Veröffentlicht in: | The American journal of surgery 2016-04, Vol.211 (4), p.761-767 |
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| creator | DeFreest, Lori, M.D., Ph.D Tafen, Marcel, M.D Bhakta, Avinash, M.D Ata, Ashar, Ph.D Martone, Stephen, M.D Glotzer, Owen, M.D Krautsak, Kevin, M.D Rosati, Carl, M.D., F.A.C.S Stain, Steven C., M.D., F.A.C.S Bonville, Daniel, D.O., F.A.C.S |
| description | Abstract Background Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. Results Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group. Conclusions In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF. |
| doi_str_mv | 10.1016/j.amjsurg.2015.11.014 |
| format | Article |
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Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. Results Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group. Conclusions In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2015.11.014</identifier><identifier>PMID: 26899958</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Confidence intervals ; Demography ; Female ; Flail chest ; Flail Chest - surgery ; Fracture Fixation, Internal - methods ; Head injuries ; Hospitals ; Humans ; Injury Severity Score ; Intensive care ; Intubation ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Mortality ; Multiple Trauma ; Nonoperative management ; Open reduction and internal fixation ; ORIF ; Ostomy ; Pain ; Patients ; Registries ; Respiration, Artificial ; Respiratory diseases ; Respiratory distress syndrome ; Retrospective Studies ; Rib fractures ; Rib Fractures - surgery ; Surgery ; Surgical outcomes ; Surgical stabilization ; Trauma Centers ; Traumatic brain injury ; Ventilation ; Ventilators</subject><ispartof>The American journal of surgery, 2016-04, Vol.211 (4), p.761-767</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-8be8864e06df1785323ca88ba008d9f38b2ef827151c0bfac3bb10b0fb1dec4d3</citedby><cites>FETCH-LOGICAL-c448t-8be8864e06df1785323ca88ba008d9f38b2ef827151c0bfac3bb10b0fb1dec4d3</cites><orcidid>0000-0002-1500-0404</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1774842204?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000,64390,64392,64394,72474</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26899958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DeFreest, Lori, M.D., Ph.D</creatorcontrib><creatorcontrib>Tafen, Marcel, M.D</creatorcontrib><creatorcontrib>Bhakta, Avinash, M.D</creatorcontrib><creatorcontrib>Ata, Ashar, Ph.D</creatorcontrib><creatorcontrib>Martone, Stephen, M.D</creatorcontrib><creatorcontrib>Glotzer, Owen, M.D</creatorcontrib><creatorcontrib>Krautsak, Kevin, M.D</creatorcontrib><creatorcontrib>Rosati, Carl, M.D., F.A.C.S</creatorcontrib><creatorcontrib>Stain, Steven C., M.D., F.A.C.S</creatorcontrib><creatorcontrib>Bonville, Daniel, D.O., F.A.C.S</creatorcontrib><title>Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. Results Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group. Conclusions In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF.</description><subject>Age</subject><subject>Confidence intervals</subject><subject>Demography</subject><subject>Female</subject><subject>Flail chest</subject><subject>Flail Chest - surgery</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Head injuries</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Intensive care</subject><subject>Intubation</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multiple Trauma</subject><subject>Nonoperative management</subject><subject>Open reduction and internal fixation</subject><subject>ORIF</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Patients</subject><subject>Registries</subject><subject>Respiration, Artificial</subject><subject>Respiratory diseases</subject><subject>Respiratory distress syndrome</subject><subject>Retrospective Studies</subject><subject>Rib fractures</subject><subject>Rib Fractures - surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical stabilization</subject><subject>Trauma Centers</subject><subject>Traumatic brain injury</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk2LFDEQhoMo7uzqT1ACXrx0W9Xpj_RFkUVXYWEP6lFCkq64aftjTLrV-femnVFhL55Chafeoh6KsScIOQLWL_pcj31cw5e8AKxyxBywvMd2KJs2QynFfbYDgCJra4Qzdh5jn0rEUjxkZ0Ut27at5I59vtnTxAN1q138PHE9ddxPC4VJD9z5n_r37-x48Ia7oO2yBooJ4ft5OCxBr6Pm-0TRtET-wy-33A3aD9zeUlwesQdOD5Een94L9untm4-X77Lrm6v3l6-vM1uWcsmkISnrkqDuHDayEoWwWkqjAWTXOiFNQU4WDVZowThthTEIBpzBjmzZiQv2_Ji7D_O3NQ1Wo4-WhkFPNK9RYdOUlYBaiIQ-u4P287pte6RkWRRQJqo6UjbMMQZyah_8qMNBIajNv-rVyb_a_CtElfynvqen9NWM1P3t-iM8Aa-OACUd3z0FFW1yZ6nzgeyiutn_d8TLOwl28JO3evhKB4r_tlGxUKA-bEew3QAmAVC2IH4Bg-evAA</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>DeFreest, Lori, M.D., Ph.D</creator><creator>Tafen, Marcel, M.D</creator><creator>Bhakta, Avinash, M.D</creator><creator>Ata, Ashar, Ph.D</creator><creator>Martone, Stephen, M.D</creator><creator>Glotzer, Owen, M.D</creator><creator>Krautsak, Kevin, M.D</creator><creator>Rosati, Carl, M.D., F.A.C.S</creator><creator>Stain, Steven C., M.D., F.A.C.S</creator><creator>Bonville, Daniel, D.O., F.A.C.S</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1500-0404</orcidid></search><sort><creationdate>20160401</creationdate><title>Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest</title><author>DeFreest, Lori, M.D., Ph.D ; Tafen, Marcel, M.D ; Bhakta, Avinash, M.D ; Ata, Ashar, Ph.D ; Martone, Stephen, M.D ; Glotzer, Owen, M.D ; Krautsak, Kevin, M.D ; Rosati, Carl, M.D., F.A.C.S ; Stain, Steven C., M.D., F.A.C.S ; Bonville, Daniel, D.O., F.A.C.S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-8be8864e06df1785323ca88ba008d9f38b2ef827151c0bfac3bb10b0fb1dec4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Age</topic><topic>Confidence intervals</topic><topic>Demography</topic><topic>Female</topic><topic>Flail chest</topic><topic>Flail Chest - surgery</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Head injuries</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Intensive care</topic><topic>Intubation</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multiple Trauma</topic><topic>Nonoperative management</topic><topic>Open reduction and internal fixation</topic><topic>ORIF</topic><topic>Ostomy</topic><topic>Pain</topic><topic>Patients</topic><topic>Registries</topic><topic>Respiration, Artificial</topic><topic>Respiratory diseases</topic><topic>Respiratory distress syndrome</topic><topic>Retrospective Studies</topic><topic>Rib fractures</topic><topic>Rib Fractures - surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical stabilization</topic><topic>Trauma Centers</topic><topic>Traumatic brain injury</topic><topic>Ventilation</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DeFreest, Lori, M.D., Ph.D</creatorcontrib><creatorcontrib>Tafen, Marcel, M.D</creatorcontrib><creatorcontrib>Bhakta, Avinash, M.D</creatorcontrib><creatorcontrib>Ata, Ashar, Ph.D</creatorcontrib><creatorcontrib>Martone, Stephen, M.D</creatorcontrib><creatorcontrib>Glotzer, Owen, M.D</creatorcontrib><creatorcontrib>Krautsak, Kevin, M.D</creatorcontrib><creatorcontrib>Rosati, Carl, M.D., F.A.C.S</creatorcontrib><creatorcontrib>Stain, Steven C., M.D., F.A.C.S</creatorcontrib><creatorcontrib>Bonville, Daniel, D.O., F.A.C.S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DeFreest, Lori, M.D., Ph.D</au><au>Tafen, Marcel, M.D</au><au>Bhakta, Avinash, M.D</au><au>Ata, Ashar, Ph.D</au><au>Martone, Stephen, M.D</au><au>Glotzer, Owen, M.D</au><au>Krautsak, Kevin, M.D</au><au>Rosati, Carl, M.D., F.A.C.S</au><au>Stain, Steven C., M.D., F.A.C.S</au><au>Bonville, Daniel, D.O., F.A.C.S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>211</volume><issue>4</issue><spage>761</spage><epage>767</epage><pages>761-767</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Background Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. Results Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group. Conclusions In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26899958</pmid><doi>10.1016/j.amjsurg.2015.11.014</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1500-0404</orcidid></addata></record> |
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| subjects | Age Confidence intervals Demography Female Flail chest Flail Chest - surgery Fracture Fixation, Internal - methods Head injuries Hospitals Humans Injury Severity Score Intensive care Intubation Length of Stay - statistics & numerical data Male Middle Aged Mortality Multiple Trauma Nonoperative management Open reduction and internal fixation ORIF Ostomy Pain Patients Registries Respiration, Artificial Respiratory diseases Respiratory distress syndrome Retrospective Studies Rib fractures Rib Fractures - surgery Surgery Surgical outcomes Surgical stabilization Trauma Centers Traumatic brain injury Ventilation Ventilators |
| title | Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest |
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