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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 wer...

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Published in:European journal of trauma and emergency surgery (Munich : 2007) 2023-12, Vol.49 (6), p.2531-2541
Main Authors: Ferreira, Rafael Oliva Morgado, Pasqualotto, Eric, Viana, Patrícia, Schmidt, Pedro Henrique Siedschlag, Andrighetti, Leonardo, Chavez, Matheus Pedrotti, Flausino, Felippe, de Oliveira Filho, Getúlio Rodrigues
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Language:English
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Summary: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 I 2 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 
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-023-02339-0