Surgical versus non-surgical treatment of flail chest: a meta-analysis of randomized controlled trials.
Purpose: Conflicting evidence exists on the choice of surgical or non-surgical treatment of flail chest injuries. We aimed to perform a meta-analysis comparing outcomes in patients presenting flail chest undergoing surgical or non-surgical treatment. Methods: Embase, PubMed, and Cochrane databases w...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 49; no. 6; pp. 2531 - 2542 |
|---|---|
| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2023
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174298335&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174298335 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Dec2023 vid: 49 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 174298335 169698605 174298335 174298335 10.1007/s00068-023-02339-0 174298335 ppf: 2531 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Surgical versus non-surgical treatment of flail chest: a meta-analysis of randomized controlled trials. aug: au: Ferreira, Rafael Oliva Morgado Pasqualotto, Eric Viana, Patrícia Schmidt, Pedro Henrique Siedschlag Andrighetti, Leonardo Chavez, Matheus Pedrotti Flausino, Felippe de Oliveira Filho, Getúlio Rodrigues affil: https://ror.org/041akq887 Federal University of Santa Catarina, R. João Pio Duarte, 144, Córrego Grande, 88037-000, Florianópolis, SC, Brazil sug: subj: Flail Chest Surgery Conservative Treatment Rib Fractures Complications Rib Fractures Surgery Emergency Medicine Thoracic Injuries Complications Treatment Outcomes Meta Analysis Systematic Review Embase PubMed Cochrane Library Confidence Intervals Respiration, Artificial Length of Stay Intensive Care Units Pneumonia Tracheostomy Fracture Fixation Human Male Female Adult Middle Age Data Analysis Software Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: Conflicting evidence exists on the choice of surgical or non-surgical treatment of flail chest injuries. We aimed to perform a meta-analysis comparing outcomes in patients presenting flail chest undergoing surgical or non-surgical treatment. Methods: Embase, PubMed, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing surgery to no surgery in patients with acute unstable chest wall injuries. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Random effects meta-analyses were performed. Heterogeneity was assessed using I2 statistics. Results: Six RCTs (544 patients) were included, and surgical treatment was used in 269 (49.4%). Compared to no surgery, surgery reduced mechanical ventilation days (WMD − 4.34, 95% CI – 6.98, − 1.69; p < 0.01; I2 = 87%; GRADE: very low; PI − 13.51, 4.84); length of intensive care unit stay (WMD − 4.62, 95% CI − 7.19, − 2.05; p < 0.01; I2 = 78%; GRADE: low; PI − 12.86, 3.61) and the incidence of pneumonia (RR 0.50, 95% CI 0.31, 0.81; p = 0.005; I2 = 54%; GRADE: moderate; PI 0.13, 1.91). No difference in mortality (RR 0.56, 95% CI 0.19, 1.65; p = 0.27; I2 = 23%; GRADE: moderate; PI 0.04, 7.25), length of hospital stay (WMD − 5.39, 95% CI − 11.38, − 0.60; p = 0.08; I2 = 89%; GRADE: very low; PI − 11.38, 0.60), or need for tracheostomy (RR 0.59, 95% CI 0.34, 1.03; p = 0.06; I2 = 54%; GRADE: moderate; PI 0.11, 3.24) was found. Conclusions: Our results suggest that surgical treatment is advantageous compared to non-surgical treatment for patients with flail chest secondary to rib fractures. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|