{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:54:57Z","timestamp":1771037697721,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T00:00:00Z","timestamp":1517356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (<jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart\u2010review study. According to ventilatory time, the patients were divided into <jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content> (\u22657\u00a0days) and shortened mechanical ventilation (<jats:styled-content style=\"fixed-case\">SMV<\/jats:styled-content>; &lt;7\u00a0days) groups. Thoracic Trauma Severity Score (<jats:styled-content style=\"fixed-case\">TTSS<\/jats:styled-content>) was calculated. To identify risk factors for <jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content>, univariate and multivariate logistic analyses and receiver operating characteristic analysis were carried out.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010four and 49 patients were assigned to <jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SMV<\/jats:styled-content> groups, respectively. Compared with the <jats:styled-content style=\"fixed-case\">SMV<\/jats:styled-content> group, the <jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content> group had a significantly larger number of fractured ribs (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01), higher rate of severe Glasgow Coma Scale (<jats:styled-content style=\"fixed-case\">GCS<\/jats:styled-content> \u22648) (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) and flail chest (<jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.001), higher <jats:styled-content style=\"fixed-case\">TTSS<\/jats:styled-content> (<jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.001), or longer intensive care unit and hospital stay (both <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001). Logistic analysis showed that severe <jats:styled-content style=\"fixed-case\">GCS<\/jats:styled-content> (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>]\u00a0=\u00a04.6, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01), flail chest (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.0, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05), and <jats:styled-content style=\"fixed-case\">TTSS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.2; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01) were independent significant risk factors. Receiver operating characteristic analyses showed that the area under the curves for <jats:styled-content style=\"fixed-case\">TTSS<\/jats:styled-content>, flail chest, and severe <jats:styled-content style=\"fixed-case\">GCS<\/jats:styled-content> were 0.74, 0.70, and 0.58, respectively. When the three factors were combined, the area under the curve increased to 0.8.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Severe <jats:styled-content style=\"fixed-case\">GCS<\/jats:styled-content> (\u22648), flail chest, or <jats:styled-content style=\"fixed-case\">TTSS<\/jats:styled-content> may be independent risk factors. Combining the three risk factors could provide high predictive performance for <jats:styled-content style=\"fixed-case\">PMV<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.331","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T04:52:40Z","timestamp":1517460760000},"page":"166-172","source":"Crossref","is-referenced-by-count":25,"title":["Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case\u2013control study"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1055-0148","authenticated-orcid":false,"given":"Yasuyuki","family":"Okabe","sequence":"first","affiliation":[{"name":"Division of Acute Care Surgery Chiba Emergency Medical Center Chiba Chiba Prefecture Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198708000-00013"},{"key":"e_1_2_8_3_1","volume-title":"Japan Trauma Data Bank Report 2016","author":"Japan Trauma Care and Research","year":"2016"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.019786"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-016-0721-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/624723"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9770-y"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-010-0027-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000086"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200009000-00018"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322011000300015"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200204000-00020"},{"key":"e_1_2_8_13_1","first-page":"193","article-title":"Pathophysiology and management of the flail chest","volume":"70","author":"Davignon K","year":"2004","journal-title":"Minerva Anestesiol."},{"key":"e_1_2_8_14_1","first-page":"7","article-title":"Lung contusion: a clinico\u2010pathological entity with unpredictable clinical course","volume":"1","author":"Ahmad Ganie F","year":"2013","journal-title":"Bull. 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