Early Outcomes of Surgical Stabilisation of Traumatic Rib Fractures: Single-Center Review With a Real-World Evidence Perspective
| Autor: | Corinna Chiong, Negin Sedaghat, Jeremy Hsu, Richard Tjahjono |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Flail chest Rib Fractures Real world evidence Single Center law.invention Time-to-Treatment 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine Randomized controlled trial law Fracture fixation medicine Flail Chest Humans Prospective Studies Aged Retrospective Studies business.industry Significant difference Length of Stay Middle Aged medicine.disease Intensive care unit Respiration Artificial Surgery Surgical morbidity Intensive Care Units Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female New South Wales business Bone Plates |
| Zdroj: | The Journal of surgical research. 264 |
| ISSN: | 1095-8673 |
| Popis: | Background Randomized controlled trials have demonstrated that surgical stabilization of rib fractures (SSRF) in selected trauma patients is associated with potential benefits. This study evaluates the real-world outcomes of SSRF since its implementation at Westmead Hospital, Australia. We hypothesize these outcomes to be similar to that reported by best-evidence in the literature. Materials and methods A retrospective analysis of data on all consecutive SSRF performed between January 2013 to December 2018 was completed. Results Sixty-three patients (54 male; average age 55.9 ± 14.1 y) with median ISS 24 (IQR 17;30) underwent SSRF. Thirty-seven patients were admitted to Intensive Care Unit (ICU), with median ICU length of stay (LOS) 10.0 (5.0-17.0) d. Median hospital LOS was 15.5 (10.0-24.8) d. Fifty-five (87.3%) patients did not have any surgery-specific complications. The highest observed surgical morbidity was wound infection (n = 4, 4.7%). There was one mortality after rib fixation that was not related to surgery. SSRF within 3 d of hospital presentation in ventilated patients with flail chest was associated with significantly reduced median ICU LOS (3.0 [2.0;4.0] versus 10.0 [9.3;13.0] d; P = 0.03). Early (2013-2015) versus late (2015-2018) phase SSRF implementation demonstrated no significant difference in outcome variables. Conclusion Experience with SSRF demonstrates early outcomes similar to best-evidence in the existing literature. As a quality assurance tool, ongoing evaluation of real-world data is needed to ensure that outcomes remain consistent with benchmarks available from best-evidence. |
| Databáze: | OpenAIRE |
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