{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T02:13:28Z","timestamp":1782785608964,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rib fractures are the most common injuries diagnosed after blunt thoracic trauma and are a source of significant morbidity and mortality. Early identification of at-risk patients and initiation of effective analgesia are keys to mitigating complications from these injuries. Multiple tools exist to predict pulmonary decompensation after rib fractures; however, none has found a widespread acceptance. A clinical practice guideline (CPG) utilizing Forced vital capacity (FVC) has been in place at a single institution. The goal of this study is to update the CPG to use percentage of predicted FVC (FVC%) instead of FVC to triage patients with rib fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective study of 266 patients with rib fractures was conducted. Patients were divided into 3 groups based on FVC of &lt;1000\u00a0mL, 1001-1500\u00a0mL, or &gt;1500\u00a0mL for analysis. Data were analyzed with analysis of variance, and Youden\u2019s J Index was used to identify inflection points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients in the high-risk category were more likely to be women, older than 65\u00a0years, admitted to the intensive care unit (ICU), transferred to the ICU, require intubation, and have overall longer hospital and ICU stays. The updated CPG triage cutoffs for admission to ICU, stepdown, and floor were redefined as FVC% values of &lt;25%, 25-45%, and &gt;45%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The updated CPG using FVC% may more accurately identify patients with compromised physiology and be a better tool to help predict patients who are at risk for decompensation following rib fractures. A validation study for the updated CPG is in progress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003134820956276","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T18:35:17Z","timestamp":1607970917000},"page":"674-679","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Utilization of Percentage of Predicted Forced Vital Capacity to Stratify Rib Fracture Patients: An Updated Clinical Practice Guideline"],"prefix":"10.1177","volume":"88","author":[{"given":"Abid D.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R.","family":"Marlor","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Billings","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian E.","family":"Leininger","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa A.","family":"Douville","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, UC Health\u2013Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley Paige","family":"Clement","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, UC Health\u2013Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Schroeppel","sequence":"additional","affiliation":[{"name":"Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"bibr1-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199412000-00018"},{"key":"bibr2-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200006000-00007"},{"key":"bibr3-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01894-X"},{"key":"bibr4-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.10.018"},{"key":"bibr5-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.07.022"},{"key":"bibr6-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1177\/000313481307900224"},{"key":"bibr7-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200009000-00018"},{"key":"bibr8-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000867"},{"key":"bibr9-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002480"},{"key":"bibr10-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2018-000257"},{"key":"bibr11-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300940"},{"key":"bibr12-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000223463.88422.6a"},{"key":"bibr13-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000744"},{"key":"bibr14-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2016.12.004"},{"key":"bibr15-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001954"},{"key":"bibr16-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2017.05.008"},{"key":"bibr17-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2017-000133"},{"key":"bibr18-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.1.9712108"},{"key":"bibr19-0003134820956276","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000613"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820956276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0003134820956276","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820956276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:34:32Z","timestamp":1777379672000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0003134820956276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1177\/0003134820956276"],"URL":"https:\/\/doi.org\/10.1177\/0003134820956276","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,14]]}}}