{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T12:28:29Z","timestamp":1790944109277,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"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":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical stabilization of rib fractures (SSRF) remains controversial as studies search for the patient population who would benefit most from SSRF. This study aimed to identify the predictive risk factors in patients with chest wall injuries who underwent SSRF and sustained in-hospital complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a retrospective review of the 2016-2019 Trauma Quality Improvement Program database. Data included age, sex, comorbidities, Abbreviated Injury Score (AIS), injury pattern, interventions, and complications. All adult patients who suffered \u22651 rib fracture following an isolated thoracic injury (AIS \u22652 but &lt; 6 and AIS \u2264 1 in all other regions) and underwent SSRF were eligible for inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1823 patients were included in this study of whom 4.8% (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 87) of patients suffered an in-hospital complication. Patients who suffered a complication were generally older, male, had a higher cardiac risk, were more severely injured, and tended to have a longer time to SSRF (3.8 vs 2.5\u00a0days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The top 5 predictors of in-hospital complications were RCRI, thorax AIS, time to SSRF, age, and sex. These variables were sufficient for achieving an acceptable discriminative ability for complications (AUC (95% CI): 0.78 (0.73-0.83)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Cardiovascular risk, thoracic injury severity, and delayed SSRF were correlated with elevated risk of complications. As time to surgery constitutes the sole changeable factor, prompt intervention may substantially diminish postoperative morbidity. These findings can enhance risk classification and assist therapeutic decision making for SSRF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251363807","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T18:53:21Z","timestamp":1753988001000},"page":"353-359","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Stabilization of Rib Fractures: Relative Importance of Risk Factors for Complications"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4550-7835","authenticated-orcid":false,"given":"Elizabeth C.","family":"Wood","sequence":"first","affiliation":[{"name":"Wake Forest School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-3443","authenticated-orcid":false,"given":"Maximilian P.","family":"Forssten","sequence":"additional","affiliation":[{"name":"\u00d6rebro University"},{"name":"\u00d6rebro University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovisa","family":"Ekestubbe","sequence":"additional","affiliation":[{"name":"\u00d6rebro University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela K.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Wake Forest University"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-9153","authenticated-orcid":false,"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"\u00d6rebro University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas P.","family":"Neff","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Sarani","sequence":"additional","affiliation":[{"name":"George Washington University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-487X","authenticated-orcid":false,"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[{"name":"\u00d6rebro University"},{"name":"Department of Surgery, New Jahra Hospital, Al Jahra Governance, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000613"},{"issue":"5","key":"e_1_3_6_3_2","first-page":"466","article-title":"Flail chest as a marker for significant injuries","volume":"178","author":"Ciraulo DL","year":"1994","unstructured":"Ciraulo DL, Elliott D, Mitchell KA, Rodriguez A. 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