A meta-analysis and trial sequential analysis of randomised controlled trials comparing nonoperative and operative management of chest trauma with multiple rib fractures.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(15):59 World J Emerg Surg . 2024 Mar 19;19(1):11.What this means for my practice?
Overall, surgical stabilization of multiple rib fractures can significantly reduce the duration of mechanical ventilation and the incidence of pneumonia, but it does not have a clear impact on mortality. The key takeaway is that while operative management may offer benefits in reducing complications, its effect on survival remains uncertain, highlighting the need for further research. The study's limitations include a small sample size and low certainty of evidence, which could affect the reliability of the findings.
Study Summary
Nine randomized controlled trials including 862 patients with traumatic multiple rib fractures were included in this systematic review and meta-analysis comparing operative management to nonoperative management. Pooled outcomes of interest included all-cause mortality, incidence of pneumonia, duration of mechanical ventilation, ICU length of stay, and hospital length of stay. The results demonstrated that operative management significantly reduced the duration of mechanical ventilation and the incidence of pneumonia, but did not significantly impact all-cause mortality. The findings suggest that while operative management may improve some clinical outcomes, further research is needed to establish its effect on mortality due to the low certainty of evidence and insufficient sample size.
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