{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:22:09Z","timestamp":1762431729403,"version":"3.37.3"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Whilst surgical stabilization of rib fractures (SSRF) results in better outcomes, selection algorithms are lacking. We aimed to validate the Rib Fracture Management Guideline proposed by Bemelman. From a cohort of 792 patients with multiple rib fractures, 2 sequential cohorts were selected: 48 patients who underwent SSRF and 48 patients who managed conservatively. Admission computed tomography scans and records were reviewed by an investigator blinded to the SSRF outcome. Adherence to the Bemelman guideline, revised to take account of consensus rib fracture definitions, was tested. Fifty-seven patients had multiple rib fractures only, and 39 patients also had a flail segment. Thirty-nine patients with flail segment underwent SSRF, and 18 patients were managed conservatively. Of the patients that the guideline predicted should have received surgery, 87% did. Of those that it predicted should not receive SSRF, 98% did not. The guideline displayed a sensitivity (95% confidence interval) and specificity for predicting the fixation of 0.98 (0.89\u20130.9995) and 0.83 (0.70\u20130.93), respectively. The positive and negative predictive values for surgical fixation were 0.87 (0.76\u20130.92) and 0.98 (0.85\u20130.99), respectively. The Bemelman guideline was thus a good predictor of SSRF in retrospective cohort but should be used in conjunction with clinical judgement. Further validation is indicated in a prospective study.<\/jats:p>","DOI":"10.1093\/icvts\/ivz317","type":"journal-article","created":{"date-parts":[[2019,12,21]],"date-time":"2019-12-21T12:05:58Z","timestamp":1576929958000},"page":"597-599","source":"Crossref","is-referenced-by-count":2,"title":["Testing the clinical validity of the Bemelman Rib Fracture Management Guideline"],"prefix":"10.1093","volume":"30","author":[{"given":"Jessica R","family":"Dorman","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"The Medical School, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter T M","family":"Clarke","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"The Medical School, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6663-6541","authenticated-orcid":false,"given":"Rosalind B","family":"Simpson","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"The Medical School, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7935-5327","authenticated-orcid":false,"given":"John G","family":"Edwards","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"key":"2020032715451522200_ivz317-B1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/TA.0000000000000086","article-title":"Flail chest injuries: a review of outcomes and treatment practices from the national trauma data bank","volume":"76","author":"Dehghan","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"2020032715451522200_ivz317-B2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00068-016-0721-2","article-title":"Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review","volume":"43","author":"Schuurmans","year":"2017","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2020032715451522200_ivz317-B3","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.injury.2016.11.026","article-title":"Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines","volume":"48","author":"Pieracci","year":"2017","journal-title":"Injury"},{"key":"2020032715451522200_ivz317-B4","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00264-017-3612-1","article-title":"Indications for surgical stabilization of rib fractures in patients without flail chest: surveyed opinions of members of the Chest Wall Injury Society","volume":"42","author":"Pieracci","year":"2018","journal-title":"Int Orthop"},{"key":"2020032715451522200_ivz317-B5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jss.2011.09.018","article-title":"Comparison of different thoracic trauma scoring systems in regards to prediction of post-traumatic complications and outcome in blunt chest trauma","volume":"176","author":"Mommsen","year":"2012","journal-title":"J Surg Res"},{"key":"2020032715451522200_ivz317-B6","article-title":"Taxonomy of multiple rib fractures: results of the chest wall injury society international consensus survey","author":"Edwards","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"key":"2020032715451522200_ivz317-B7","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5090\/kjtcs.2017.50.4.229","article-title":"Rib fractures: to fix or not to fix? An evidence-based algorithm","volume":"50","author":"Bemelman","year":"2017","journal-title":"Korean J Thorac Cardiovasc Surg"},{"key":"2020032715451522200_ivz317-B8"},{"key":"2020032715451522200_ivz317-B9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1093\/ejcts\/ezz020","article-title":"Unifying classification of transdiaphragmatic intercostal hernia and other costal margin injuries","volume":"56","author":"Gooseman","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020032715451522200_ivz317-B10","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/TA.0000000000001350","article-title":"Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma","volume":"82","author":"Kasotakis","year":"2017","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Interactive CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/30\/4\/597\/32973995\/ivz317.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/30\/4\/597\/32973995\/ivz317.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T19:45:52Z","timestamp":1585338352000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/30\/4\/597\/5714626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,23]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,1,23]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivz317","relation":{},"ISSN":["1569-9285"],"issn-type":[{"type":"electronic","value":"1569-9285"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2020,1,23]]}}}