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. 2019 Jan-Feb;33(1):133-139.
doi: 10.21873/invivo.11449.

Limited Influence of Flail Chest in Patients With Blunt Thoracic Trauma - A Matched-pair Analysis

Peter Getz  1 , Philipp Mommsen  1 , Jan-Dierk Clausen  1 , Marcel Winkelmann  2
Affiliations

Limited Influence of Flail Chest in Patients With Blunt Thoracic Trauma - A Matched-pair Analysis

Peter Getz et al. In Vivo. 2019 Jan-Feb.

Abstract

Background: Flail chest is considered as one of the most severe forms of blunt thoracic trauma. However, its actual influence on post-traumatic morbidity and mortality is debatable.

Materials and methods: A retrospective cohort analysis was performed of multiply injured patients (injury severity score ≥16) at a level I trauma center. Flail chest was defined as segment fracture of at least three consecutive ribs on at least one side. Propensity score matching was performed.

Results: A total of 600 patients were included, with a mean age of 44.1±19.1 years and a mean injury severity score of 31.6±10.4. Overall, 367 patients (61.2%) had a serial rib fracture. Forty-five patients (7.5%) presented with flail chest. Patients with flail chest more often had lung contusions (70 vs. 50%, p=0.04) and pneumo-/hematothorax (93 vs. 71%, p=0.005). There were no differences in post-traumatic morbidity and mortality.

Conclusion: Flail chest had no independent influence in addition to injury severity on post-traumatic morbidity and mortality in multiply injured patients with blunt thoracic trauma.

Keywords: Multiple injuries; acute respiratory distress syndrome; flail chest; serial rib fracture; thoracic trauma.

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Figures

Figure 1
Figure 1. Flow diagram of study patients.
See this image and copyright information in PMC

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