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Surgical stabilization linked with decreased mortality risk among patients with flail chest injuries
Patients with flail chest injuries who underwent surgical stabilization experienced a decrease in early mortality compared with patients who had nonoperative care, according to results.
From 2004 to 2015, Niloofar Dehghan, MD, and colleagues assessed the rate of surgical repair, days on mechanical ventilation, days in the ICU, days in hospital, rate of chest tube placement and rates of complication, including pneumonia, tracheostomy, readmission and death, among 117,204 patients with fractures of the chest wall identified as either a flail chest injury (1.5%), multiple rib fractures without flail chest injury (41%) or single rib/sternum fractures (58%).
Results showed significantly worse outcomes in all categories among patients with flail chest injuries vs. multiple rib fractures and among patients with multiple rib fractures vs. single rib fractures. Although surgical treatment occurred in 4.5% of patients with flail chest injuries, researchers found the number of surgical treatments increased from 1% before 2010 to 10% after 2010. Compared to patients with flail chest injuries treated nonoperatively, researchers identified a reduced risk of early mortality among patients with flail chest injuries treated surgically, after adjusting for potential confounders.
“The diagnosis of flail chest injury has a significantly higher risk of morbidity and mortality for patients compared to those with multiple rib fractures who do not have a flail chest,” Dehghan told Healio.com/Orthopedics. “Also, surgical fixation of flail chest injuries has increased in the past few years, and may be associated with a lower mortality compared to those treated nonoperatively.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.