التفاصيل البيبلوغرافية
| العنوان: |
Nonoperative treatment of multiple rib fractures, the results to beat: International multicenter prospective cohort study among 845 patients |
| المؤلفون: |
Peuker, Felix, Hoepelman, Ruben J., Beeres, Frank J.P., Balogh, Zsolt J., Beks, Reinier B., Sweet, Arthur A.R., Ijpma, Frank F.A., Lansink, Koen W.W., Van Wageningen, Bas, Tromp, Tjarda N., Minervini, Fabrizio, Van Veelen, Nicole M., Hoogendoorn, Jochem M., De Jong, Mirjam B., Van Baal, Mark C.P.M., Leenen, Luke P.H., Groenwold, Rolf H.H., Houwert, R. Marijn |
| المساهمون: |
Zorgeenheid Traumatologie, Researchgr. Systems Radiology, Cancer, Infection & Immunity, Epi Methoden Team 1, Other research (not in main researchprogram) |
| سنة النشر: |
2024 |
| مصطلحات موضوعية: |
conservative treatment, mortality, Multiple rib fractures, nonoperative treatment, pneumonia rate, quality of life, Surgery, Critical Care and Intensive Care Medicine |
| الوصف: |
BACKGROUND Optimal treatment (i.e., nonoperative or operative) for patients with multiple rib fractures remains debated. Studies that compare treatments are rationalized by the alleged poor outcomes of nonoperative treatment. METHODS The aim of this prospective international multicenter cohort study (between January 2018 and March 2021) with 1-year follow-up, was to report contemporary outcomes of nonoperatively treated patients with multiple rib fractures. Including 845 patients with three or more rib fractures. Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), (pulmonary) complications, and quality of life. RESULTS Mean age was 57.7 ± 17.0 years, median Injury Severity Score was 17 (13-22) and the median number of rib fractures was 6 (4-8). In-hospital mortality rate was 1.5% (n = 13), 112 (13.3%) patients had pneumonia and four (0.5%) patients developed a symptomatic nonunion. The median HLOS was 7 days (4-13 days), and median intensive care unit length of stay was 2 days (1-5 days). Mean 5-Level Quality of Life Questionnaire index value was 0.83 ± 0.18 1 year after trauma. Polytrauma patients had a median HLOS of 10 days (6-18 days), a pneumonia rate of 17.6% (n = 77) and mortality rate of 1.7% (n = 7). Elderly patients (≥65 years) had a median HLOS of 9 days (5-15 days), a pneumonia rate of 19.7% (n = 57) and mortality rate of 4.1% (n = 12). CONCLUSION Overall, nonoperative treatment of patients with multiple rib fractures shows low mortality and morbidity rate and good quality of life after 1 year. Future studies evaluating the benefit of operative stabilization should use contemporary outcomes to establish the therapeutic margin of rib fixation. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| تدمد: |
2163-0755 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/455269 |
| الاتاحة: |
https://dspace.library.uu.nl/handle/1874/455269 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: |
edsbas.EA75D86C |
| قاعدة البيانات: |
BASE |