{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T12:28:33Z","timestamp":1790944113374,"version":"4.1.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"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":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Although randomized trials demonstrate a benefit to surgical stabilization of rib fractures (SSRF), SSRF is rarely performed. We hypothesized older patients were less likely to receive SSRF nationally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2016 National Inpatient Sample was used to identify adults with flail chest. Comorbidities and receipt of SSRF were categorized by ICD-10 code. Univariable testing and Multivariable regression were performed to determine the association of demographic characteristics and comorbidities to receipt of SSRF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1021 patients with flail chest were identified, including 244 (23.9%) who received SSRF. Patients \u226570\u00a0years were less likely to receive SSRF. (&lt;70\u00a0yrs 201\/774 [26.0%] vs \u226570 43\/247 [17.4%], P = .006) and had higher risk of death (&lt;70\u00a0yrs 39\/774 [5.0%] vs \u226570 33\/247 [13.4%], P &lt; .001) In multivariable modeling, only age \u226570 years was associated with SSRF (OR .591, P = .005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite guideline-based support of SSRF in flail chest, SSRF is performed in &lt;25% of patients. Age \u226570\u00a0years is associated with lower rate of SSRF and higher risk of death. Future study should examine barriers to SSRF in older patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211047490","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T22:32:17Z","timestamp":1635978737000},"page":"927-934","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Age as a Barrier to Surgical Stabilization of Rib Fractures in Patients with Flail Chest"],"prefix":"10.1177","volume":"89","author":[{"given":"Naomi","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelynn C.","family":"Bachman","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Linden","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa P.","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Trauma, Critical Care, Burns, & Acute Care Surgery, Department of Surgery, MetroHealth Medical Center, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Moorman","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie G.","family":"Worrell","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Argote-Greene","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Towe","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals 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