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  • Title: Limited Influence of Flail Chest in Patients With Blunt Thoracic Trauma - A Matched-pair Analysis.
    Author: Getz P, Mommsen P, Clausen JD, Winkelmann M.
    Journal: In Vivo; 2019; 33(1):133-139. PubMed ID: 30587613.
    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.
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