{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:17:06Z","timestamp":1772464626231,"version":"3.50.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Trauma Acute Care Surg"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Early surgical stabilization of rib fractures (SSRF) is associated with improved inpatient outcomes in patients with multiple rib fractures. However, there is still a paucity of data examining the optimal timing of SSRF in patients with concomitant traumatic brain injury (TBI). This study aimed to assess whether earlier SSRF was associated with improved outcomes in patients with multiple rib fractures and TBI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>We performed a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program 2017\u20132020, including adult patients with TBI and multiple rib fractures who had undergone SSRF. The outcomes were post-procedural length of stay (LOS), hospital LOS, intensive care unit (ICU) LOS, in-hospital mortality, ventilator days, and tracheostomy rate. Multilevel mixed-effects regression analyses accounting for patient, injury, and hospital characteristics as well as institutional SSRF volume were used to assess the association between timing to SSRF and the outcomes of interest. As a sensitivity analysis, propensity-score matching was performed to compare patients who underwent early (&lt;72 hours) versus late SSRF (\u226572 hours).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Of 1,041 patients included in this analysis, 430 (41.3%) underwent SSRF within the first 72 hours from admission. Delay to SSRF was associated with an increase in post-procedural LOS (partial regression coefficient (\u03b2) = 0.011; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.036; 95% confidence interval [CI], 0.001\u20130.023), longer hospital LOS (\u03b2 = 0.053; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001; 95% CI, 0.042\u20130.064), prolonged ICU LOS (\u03b2 = 0.032; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001; 95% CI, 0.025\u20130.038), and more ventilator days (\u03b2 = 0.026, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001; 95% CI, 0.020\u20130.032).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>In patients with concurrent multiple rib fractures and TBI, a delay in SSRF is associated with an increase in postprocedural LOS, hospital LOS, ICU LOS, and ventilator days. These findings suggest that the early patient selection and implementation of SSRF may play a beneficial role in patients presenting with concomitant TBI and multiple rib fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE<\/jats:title>\n            <jats:p>Therapeutic\/Care Management; Level IV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ta.0000000000004100","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T01:00:07Z","timestamp":1700442007000},"page":"846-854","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Evaluating the impact of timing to rib fixation in patients with traumatic brain injury: A nationwide analysis"],"prefix":"10.1097","volume":"95","author":[{"given":"Emanuele","family":"Lagazzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dias","family":"Argandykov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amory","family":"de Roulet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jefferson A.","family":"Proa\u00f1o-Zamudio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Sophie C.","family":"Romijn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May","family":"Abiad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wardah","family":"Rafaqat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Velmahos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John O.","family":"Hwabejire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charudutt N.","family":"Paranjape","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"issue":"6","key":"bib1-20250806","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1097\/00005373-199412000-00018","article-title":"The morbidity and mortality of rib fractures","volume":"37","year":"1994","journal-title":"J Trauma"},{"issue":"1","key":"bib2-20250806","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2106\/JBJS.I.00696","article-title":"Operative treatment of chest wall injuries: indications, technique, and outcomes","volume":"93","year":"2011","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"bib3-20250806","doi-asserted-by":"crossref","first-page":"e0268202","DOI":"10.1371\/journal.pone.0268202","article-title":"Road traffic accident-related thoracic trauma: epidemiology, injury pattern, outcome, and impact on mortality\u2014a multicenter observational study","volume":"17","year":"2022","journal-title":"PLoS One"},{"issue":"6","key":"bib4-20250806","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1097\/TA.0000000000001648","article-title":"Quantifying and exploring the recent national increase in surgical stabilization of rib fractures","volume":"83","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"bib5-20250806","first-page":"727","article-title":"Surgical stabilization of internal pneumatic stabilization? 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