{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:17:02Z","timestamp":1772464622211,"version":"3.50.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum M\u00fcnster"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Severe thorax trauma including multiple rib fractures and flail chest deformity are leading causes of death in trauma patients. Increasing evidence supports the use of surgical stabilisation of rib fractures (SSRF) in these patients. However, there is currently a paucity of evidence for its use in non-ventilator-dependent patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective propensity-matched analysis of the data of the TraumaRegister DGU\n                      <jats:sup>\u00ae<\/jats:sup>\n                      for non-ventilator-dependent patients with severe rib injury (abbreviated injury score\u2009\u2265\u20093) was performed. Subgroup analyses with respect to injury severity score, American society of anaesthesiologists physical status classification and age were performed. Furthermore, the effect of time to surgery was analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>TR-DGU project ID 2023-007; ClinicalTrials.gov protocol ID: NCT06464289.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SSRF led to reduced mortality compared to conservative treatment (1.6% vs. 4.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and in comparison to the mortality prognosis of the revised injury severity classification II (RISC II) of 5.2%. Interestingly, SSRF was associated with increased length of hospital and intensive care unit stay, higher rates of organ failure and secondary intubation. The patients with organ failure received SSRF later than those without organ failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Here we report on the largest currently published dataset of non-intubated patients receiving SSRF, which showed reduced mortality in the SSRF cohort. The data indicates that SSRF is a viable treatment option for non-intubated patients. The observed late surgical time points, which may be due to cross over after failed conservative treatment, might be the cause for the observed increased rate of organ failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-024-02756-9","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T11:09:50Z","timestamp":1737716990000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical stabilisation of rib fractures in non-ventilated patients: a retrospective propensity-matched analysis using the data from the trauma registry of the German Trauma Society (TraumaRegister DGU\u24c7)"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-0471","authenticated-orcid":false,"given":"Michael D.","family":"Huelskamp","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Duesing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Lefering","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Raschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Rosslenbroich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"TraumaRegister DGU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"issue":"3","key":"2756_CR1","first-page":"297","volume":"161","author":"A Wilharm","year":"2021","unstructured":"Wilharm A, Pflug A, Loos F, Sommerfeld O, Hofmann GO, Sauer S. Todesursachen Von Schwerverletzten - Woran stirbt das Polytrauma heute? Z Orthop Unfall. 2021;161(3):297\u2013303.","journal-title":"Z Orthop Unfall"},{"key":"2756_CR2","unstructured":"Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019. (GBD 2019)."},{"issue":"5","key":"2756_CR3","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1097\/TA.0000000000002205","volume":"86","author":"RA Callcut","year":"2019","unstructured":"Callcut RA, Kornblith LZ, Conroy AS, Robles AJ, Meizoso JP, Namias N, et al. The why and how our trauma patients die: a prospective Multicenter Western Trauma Association study. J Trauma Acute Care Surg. 2019;86(5):864\u201370.","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"2756_CR4","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s13049-017-0384-y","volume":"25","author":"K Chrysou","year":"2017","unstructured":"Chrysou K, Halat G, Hoksch B, Schmid RA, Kocher GJ. Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients\u2014still a relevant problem? Scand J Trauma Resusc Emerg Med. 2017;25(1):42.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2756_CR5","unstructured":"H\u00f6fer C, Lefering R, Jahresbericht DGU. 2022. Jahresbericht 2022 - TraumaRegister DGU\u00ae f\u00fcr das Unfalljahr 2021. 2022;36."},{"issue":"1","key":"2756_CR6","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s00068-020-01412-2","volume":"48","author":"J Peek","year":"2022","unstructured":"Peek J, Beks RB, Hietbrink F, De Jong MB, Heng M, Beeres FJP, IJpma FFA, Leenen LPH, Groenwold RHH, Houwert RM. Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands. Eur J Trauma Emerg Surg. 2022;48(1):265\u201371.","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"2","key":"2756_CR7","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/ageing\/afz157","volume":"49","author":"R Coary","year":"2020","unstructured":"Coary R, Skerritt C, Carey A, Rudd S, Shipway D. New horizons in rib fracture management in the older adult. Age Ageing. 2020;49(2):161\u20137.","journal-title":"Age Ageing"},{"issue":"2","key":"2756_CR8","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.thorsurg.2017.01.004","volume":"27","author":"S Majercik","year":"2017","unstructured":"Majercik S, Pieracci FM. Chest Wall Trauma. Thorac Surg Clin. 2017;27(2):113\u201321.","journal-title":"Thorac Surg Clin"},{"issue":"4","key":"2756_CR9","first-page":"249","volume":"104","author":"S Craxford","year":"2022","unstructured":"Craxford S, Owyang D, Marson B, Rowlins K, Coughlin T, Forward D, Ollivere B. Surgical management of rib fractures after blunt trauma: a systematic review and meta-analysis of randomised controlled trials. Ann R Coll Surg Engl. 2022;104(4):249\u201356.","journal-title":"Ann R Coll Surg Engl"},{"key":"2756_CR10","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.jss.2022.02.055","volume":"276","author":"E Sawyer","year":"2022","unstructured":"Sawyer E, Wullschleger M, Muller N, Muller M. Surgical Rib fixation of multiple Rib fractures and flail chest: a systematic review and Meta-analysis. J Surg Res. 2022;276:221\u201334.","journal-title":"J Surg Res"},{"key":"2756_CR11","first-page":"631","volume-title":"Fixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis","author":"RB Beks","year":"2019","unstructured":"Beks RB, Peek J, de Jong MB, Wessem KJP, \u00d6ner CF, Hietbrink F, Leenen LPH, Groenwold RHH, Houwert RM. Fixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis. European Journal of Trauma and Emergency Surgery. Volume 45. Berlin Heidelberg: Springer; 2019. pp. 631\u201344."},{"issue":"2","key":"2756_CR12","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/TA.0000000000002559","volume":"88","author":"FM Pieracci","year":"2020","unstructured":"Pieracci FM, Leasia K, Bauman Z, Eriksson EA, Lottenberg L, Majercik S, Powell L, Sarani B, Semon G, Thomas B, Zhao F, Dyke C, Doben AR. A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL). J Trauma Acute Care Surg. 2020;88(2):249\u201357.","journal-title":"J Trauma Acute Care Surg"},{"issue":"6","key":"2756_CR13","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1097\/TA.0000000000003549","volume":"92","author":"SF Marasco","year":"2022","unstructured":"Marasco SF, Balogh ZJ, Wullschleger ME, Hsu J, Patel B, Fitzgerald M, Martin K, Summerhayes R, Bailey M. Rib fixation in non\u2013ventilator-dependent chest wall injuries: a prospective randomized trial. J Trauma Acute Care Surg. 2022;92(6):1047\u201353.","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"2756_CR14","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.amjsurg.2018.02.022","volume":"216","author":"F Ali-Osman","year":"2018","unstructured":"Ali-Osman F, Mangram A, Sucher J, Shirah G, Johnson V, Moeser P, Sinchuk NK, Dzandu JK. Geriatric (G60) trauma patients with severe rib fractures: is muscle sparing minimally invasive thoracotomy rib fixation safe and does it improve post-operative pulmonary function? Am J Surg. 2018;216(1):46\u201351.","journal-title":"Am J Surg"},{"issue":"5","key":"2756_CR15","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","volume":"13","author":"S Cuschieri","year":"2019","unstructured":"Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(5):S31\u20134.","journal-title":"Saudi J Anaesth"},{"issue":"4","key":"2756_CR16","doi-asserted-by":"publisher","first-page":"2773","DOI":"10.1007\/s00068-021-01864-0","volume":"48","author":"L Becker","year":"2022","unstructured":"Becker L, Schulz-Drost S, Spering C, Franke A, Dudda M, Lefering R, Matthes G, Bieler D. Effect of surgical stabilization of rib fractures in polytrauma: an analysis of the TraumaRegister DGU\u00ae. Eur J Trauma Emerg Surg. 2022;48(4):2773\u201381.","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"1","key":"2756_CR17","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/BOT.0000000000000992","volume":"32","author":"N Dehghan","year":"2018","unstructured":"Dehghan N, Mah JM, Schemitsch EH, Nauth A, Vicente M, McKee MD. Operative stabilization of flail chest injuries reduces mortality to that of stable chest wall injuries. J Orthop Trauma. 2018;32(1):15\u201321.","journal-title":"J Orthop Trauma"},{"issue":"5","key":"2756_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-014-0476-2","volume":"18","author":"R Lefering","year":"2014","unstructured":"Lefering R, Huber-Wagner S, Nienaber U, Maegele M, Bouillon B. Update of the trauma risk adjustment model of the TraumaRegister DGU\u2122: the revised Injury Severity classification, version II. Crit Care. 2014;18(5):1\u201312.","journal-title":"Crit Care"},{"issue":"Suppl 1","key":"2756_CR19","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.21037\/jtd-21-649","volume":"13","author":"JTH Prins","year":"2021","unstructured":"Prins JTH, Wijffels MME, Pieracci FM. What is the optimal timing to perform surgical stabilization of rib fractures? J Thorac Dis. 2021;13(Suppl 1):S13\u201325.","journal-title":"J Thorac Dis"},{"issue":"1","key":"2756_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/TA.0000000000001729","volume":"84","author":"FM Pieracci","year":"2018","unstructured":"Pieracci FM, Coleman J, Ali-Osman F, Mangram A, Majercik S, White TW, Jeremitsky E, Doben AR. A multicenter evaluation of the optimal timing of surgical stabilization of rib fractures. J Trauma Acute Care Surg. 2018;84(1):1\u201310.","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"2756_CR21","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.injury.2016.11.026","volume":"48","author":"FM Pieracci","year":"2017","unstructured":"Pieracci FM, Majercik S, Ali-Osman F, Ang D, Doben A, Edwards JG, French B, Gasparri M, Marasco S, Minshall C, Sarani B, Tisol W, VanBoerum DH, White TW. Consensus statement: Surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury. 2017;48(2):307\u201321.","journal-title":"Injury"},{"issue":"May","key":"2756_CR22","first-page":"1","volume":"9","author":"L Becker","year":"2022","unstructured":"Becker L, Schulz-Drost S, Spering C, Franke A, Dudda M, Kamp O, Lefering R, Matthes G, Bieler D. Impact of time of surgery on the Outcome after Surgical stabilization of Rib fractures in severely injured patients with severe chest Trauma\u2014A matched-pairs analysis of the German Trauma Registry. Front Surg. 2022;9(May):1\u20137.","journal-title":"Front Surg"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02756-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-024-02756-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02756-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T11:04:56Z","timestamp":1770721496000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-024-02756-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2756"],"URL":"https:\/\/doi.org\/10.1007\/s00068-024-02756-9","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]},"assertion":[{"value":"16 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"55"}}