دورية أكاديمية
A meta-analysis and trial sequential analysis of randomised controlled trials comparing nonoperative and operative management of chest trauma with multiple rib fractures
العنوان: | A meta-analysis and trial sequential analysis of randomised controlled trials comparing nonoperative and operative management of chest trauma with multiple rib fractures |
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المؤلفون: | Ryo Hisamune, Mako Kobayashi, Karin Nakasato, Taiga Yamazaki, Noritaka Ushio, Katsunori Mochizuki, Akira Takasu, Kazuma Yamakawa |
المصدر: | World Journal of Emergency Surgery, Vol 19, Iss 1, Pp 1-12 (2024) |
بيانات النشر: | BMC, 2024. |
سنة النشر: | 2024 |
المجموعة: | LCC:Surgery LCC:Medical emergencies. Critical care. Intensive care. First aid |
مصطلحات موضوعية: | Chest trauma, Flail chest, Fracture stabilization, Rib fractures, Surgery fixation, Thoracic injury, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
الوصف: | Abstract Background Operative treatment of traumatic rib fractures for better outcomes remains under debate. Surgical stabilization of rib fractures has dramatically increased in the last decade. This study aimed to perform a systematic review and meta-analysis of randomised controlled trials (RCTs) to assess the effectiveness and safety of operative treatment compared to conservative treatment in adult patients with traumatic multiple rib fractures. Methods A systematic literature review was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines. We searched MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials and used the Cochrane Risk-of-Bias 2 tool to evaluate methodological quality. Relative risks with 95% confidence interval (CI) were calculated for outcomes: all-cause mortality, pneumonia incidence, and number of mechanical ventilation days. Overall certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, with trial sequential analysis performed to establish implications for further research. Results From 719 records, we included nine RCTs, which recruited 862 patients. Patients were assigned to the operative group (received surgical stabilization of chest wall injury, n = 423) or control group (n = 439). All-cause mortality was not significantly different (RR = 0.53; 95% CI 0.21 to 1.38, P = 0.35, I 2 = 11%) between the two groups. However, in the operative group, duration of mechanical ventilation (mean difference -4.62; 95% CI -7.64 to -1.60, P |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 1749-7922 |
Relation: | https://doaj.org/toc/1749-7922 |
DOI: | 10.1186/s13017-024-00540-z |
URL الوصول: | https://doaj.org/article/5e42c7b87bd34221a7b9dab2c02c4bc7 |
رقم الأكسشن: | edsdoj.5e42c7b87bd34221a7b9dab2c02c4bc7 |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 17497922 |
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DOI: | 10.1186/s13017-024-00540-z |