The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021)

Kong, Lingwen; Huang, Guangbin; Yi, Yongxiang; Du, Dingyuan

doi:10.1016/j.cjtee.2021.07.012

Cited by 8 publications

(5 citation statements)

References 65 publications

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“…According to the Chinese consensus for the surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021) ( 1 ), SSRF is recommended for multiple rib fractures with flail chest (IIA). Patients without surgical contraindications and without flail chest can also benefit from surgical treatment (IIB).…”

Section: Discussionmentioning

confidence: 99%

“…The main cause of injury in the elderly is blunt trauma ( 29 ). Elderly people are more likely to develop hemothorax after blunt trauma ( 1 ). The elderly is frailer, leading to higher rates of anticoagulant drug use ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…At present, there is no complete Chinese database of chest trauma patients, and it is difficult to obtain accurate data on chest trauma. It is conservatively estimated that the number of patients with rib fracture is 1.5 million to 2 million per year ( 1 ). With population ageing, the proportion of middle-aged and elderly rib fracture patients is increasing yearly ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of surgical outcomes in elderly patients with rib fractures: A single-centre propensity score matching study

Zhang

Jiao

et al. 2023

Front. Surg.

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BackgroundRib fractures are the most common injuries in chest trauma. Compared with younger patients, elderly patients with rib fracture have a higher incidence of complications and mortality. A retrospective study was conducted to investigate the effect of internal fixation compared with conservative treatment on the outcome of rib fracture in elderly patients.Material and methodsWe used a 1:1 propensity score matching method to perform a retrospective analysis of 703 elderly patients with rib fractures treated in the Thoracic Surgery Department of Beijing Jishuitan Hospital between 2013 and 2020. After matching, the length of hospital stay, death, symptom relief and rib fracture healing were compared between the surgery and the control group.ResultsThe study included 121 patients receiving SSRF in the surgery group and 121 patients receiving conservative treatment in the control group. The length of hospital stay in the surgery group was significantly longer than that in the conservative group (11.39d vs. 9.48d, p = 0.000). After 9 months of follow-up, the fracture healing rate in the surgery group was significantly higher than that in the control group (96.67% vs. 88.89%, p = 0.020). The fracture healing time (p = 0.000), improvement in pain score (p = 0.000) and duration of pain medication use (p = 0.000) were also significantly better in the surgery group than in the control group.ConclusionCompared with conservative treatment, surgical treatment can prolong hospital stay to some extent. However, it has the advantages of more rapid healing and lessened pain. For rib fractures in elderly individuals, surgical treatment is a safe and effective option under strict surgical indications and is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of surgical outcomes in elderly patients with rib fractures: A single-centre propensity score matching study

Zhang

Jiao

et al. 2023

Front. Surg.

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“…We performed a retrospective cohort study at Chongqing Emergency Medical Center, an urban teaching hospital with 1,200 beds in China, between January 2011 and December 2021. The study included patients with flail chest, defined as at least 3 or 4 consecutive rib fractures in at least two places causing paradoxical movement of the chest wall (2). We excluded patients <18 years of age, patients who died within 48 h of admission or had pneumonia before referral to our institution, and patients with rib fractures due to cardiopulmonary resuscitation (Figure 1).…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…Flail chest is the most severe type of chest trauma, is found in approximately 4% of patients with rib fractures and is defined as at least 3 or 4 consecutive rib fractures in at least two places causing paradoxical movement of the chest wall (1,2). It has been described in 30% of patients with significant chest trauma requiring intensive care, and flail chest has an adverse impact on their respiratory function and causes several associated complications, such as pneumonia and acute respiratory distress syndrome (ARDS) (3).…”

Section: Introductionmentioning

confidence: 99%

Predicting pneumonia during hospitalization in flail chest patients using machine learning approaches

Song

Chen

et al. 2023

Front. Surg.

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ObjectivePneumonia is a common pulmonary complication of flail chest, causing high morbidity and mortality rates in affected patients. The existing methods for identifying pneumonia have low accuracy, and their use may delay antimicrobial therapy. However, machine learning can be combined with electronic medical record systems to identify information and assist in quick clinical decision-making. Our study aimed to develop a novel machine-learning model to predict pneumonia risk in flail chest patients.MethodsFrom January 2011 to December 2021, the electronic medical records of 169 adult patients with flail chest at a tertiary teaching hospital in an urban level I Trauma Centre in Chongqing were retrospectively analysed. Then, the patients were randomly divided into training and test sets at a ratio of 7:3. Using the Fisher score, the best subset of variables was chosen. The performance of the seven models was evaluated by computing the area under the receiver operating characteristic curve (AUC). The output of the XGBoost model was shown using the Shapley Additive exPlanation (SHAP) method.ResultsOf 802 multiple rib fracture patients, 169 flail chest patients were eventually included, and 86 (50.80%) were diagnosed with pneumonia. The XGBoost model performed the best among all seven machine-learning models. The AUC of the XGBoost model was 0.895 (sensitivity: 84.3%; specificity: 80.0%).Pneumonia in flail chest patients was associated with several features: systolic blood pressure, pH value, blood transfusion, and ISS.ConclusionOur study demonstrated that the XGBoost model with 32 variables had high reliability in assessing risk indicators of pneumonia in flail chest patients. The SHAP method can identify vital pneumonia risk factors, making the XGBoost model's output clinically meaningful.

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Does the timing of surgery affect outcomes in young and middle-aged patients undergoing surgical stabilization of rib fractures? Feedback was based on real data from physicians, patients, and family caregivers

Wang

Jing

et al. 2023

Eur J Trauma Emerg Surg

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The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021)

Cited by 8 publications

References 65 publications

Evaluation of surgical outcomes in elderly patients with rib fractures: A single-centre propensity score matching study

Evaluation of surgical outcomes in elderly patients with rib fractures: A single-centre propensity score matching study

Predicting pneumonia during hospitalization in flail chest patients using machine learning approaches

Does the timing of surgery affect outcomes in young and middle-aged patients undergoing surgical stabilization of rib fractures? Feedback was based on real data from physicians, patients, and family caregivers

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