Risk factors for adverse outcomes in older adults with blunt chest trauma: A systematic review

Abstract

While blunt chest wall trauma in older adults is relatively common, the literature on prognostic factors for adverse outcomes in this patient population remains inadequate due to a paucity of high quality studies and lack of consistent reporting standards.

Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference

“…Four couples of reviewers performed a blind inclusion procedure and literature assessment, supported by the literature review expert and the STC members. In summary, 2 guidelines [12,13]; 8 evidence-based synthesis, health technology documents, and documents by scientific societies [14][15][16][17][18][19][20][21]-in the following, we will indicate with "synthesis of evidence documents" these documents-7 systematic reviews [22][23][24][25][26][27][28]; 3 non-systematic reviews [29][30][31]; 20 primary studies [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]; and 10 theoretical/doctrinal documents [7,8,[52][53][54][55][56]…”

“…Overall, the quality of the observational studies was good, while that of systematic and non-systematic reviews was poor (there were no high quality systematic reviews); one of the guidelines was of high quality, while the other was of average quality ( Table 1). Theoretical/doctrinal documents and [33] Primary study *** Brown et al 2017 [22] Systematic review *** Callahan et al 2000 [34] Primary study *** Callahan et al 2004 [35] Primary study **** Chipi et al 2018 [36] Primary study **** Clayman et al 2005 [37] Primary study **** Corbi et al 2018 [38] Primary study **** Deveugele et al 2002 [39] Primary study **** Ferrari et al 2017 [40] Primary study **** Gardner et al 2018 [29] Narrative review * Girtler et al 2012 [41] Primary study *** Hashmi et al 2014 [23] S y s t e m a t i c r e v i e w * Hildebrand et al 2016 [30] R e v i e w * Hogan et al 2011 [31] R e v i e w * Ishikawa et al 2005 [42] Primary study *** Laidsaar-Powell et al 2013 [24] S y s t e m a t i c r e v i e w * * McIntyre et al 2013 [25] S y s t e m a t i c r e v i e w * New Zealand Guidelines Group 2003 [12] Guideline **** Petek Ster et al 2008 [43] Primary study **** Regione Toscana 2017 [13] Guideline *** Reuben et al 2004 [44] Primary study **** Sammy et al 2016 [26] S y s t e m a t i c r e v i e w * * Sawa et al 2018 [27] Systematic review *** Schmidt et al 2009 [45] Primary study *** Storti 2009 [46] Primary study *** Tähepold et al 2003 [47] Primary study *** Wolff et al 2008 [48] Primary study **** Wolff et al 2011 [28] S y s t e m a t i c r e v i e w * * Wolff et al 2012 [49] Primary study **** Wolff et al 2017 [50] Primary study ** Wooldridge et al 2010 [51] Primary study **** synthesis of evidence documents were excluded from the quality assess...…”

“…Several reviews found a direct association between ageing and mortality after major traumas [23,[25][26][27]30]. However, it is not clear whether age represents an independent factor, and it is generally difficult to establish an age threshold over which mortality significantly increases [29,30].…”

Implementation Evaluation of a Multidisciplinary Blunt Chest Injury Care Bundle (ChIP): Fidelity of Delivery

“…Blunt chest injury is often painful and impairs normal respiratory function [1,3]. Ineffective or delayed treatment for blunt chest injury results in high morbidity and mortality, especially for older patients where each additional rib fracture increases the risk of mortality by 19% and of pneumonia by 27% [4,5]. As such, there is a need to implement strategies to improve the care and outcomes of people with rib fractures [6].…”

Implementation Evaluation of a Multidisciplinary Blunt Chest Injury Care Bundle (ChIP): Fidelity of Delivery

“…Blunt chest injury is often painful and impairs normal respiratory function [1,3]. Ineffective or delayed treatment for blunt chest injury results in high morbidity and mortality, especially for patients aged 65 and older, where each additional rib fracture increases the risk of mortality by 19% and pneumonia by 27% [4,5]. As such, there is a need to implement strategies to improve the care and outcomes of people with rib fractures [6].…”