{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:06:25Z","timestamp":1779789985514,"version":"3.53.1"},"reference-count":41,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"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":[[2026,7]]},"abstract":"<jats:p>\n                    Sex-based differences in rib fracture presentation and recovery may influence surgical stabilization of rib fractures (SSRF) outcomes. Greater chest wall muscle mass in males may necessitate higher-energy trauma to cause rib fractures, increasing the risk of respiratory complications. Objective: We compared the rates of SSRF in male and female blunt trauma patients (BTPs) with rib fractures, hypothesizing that males would undergo SSRF at a higher rate and experience increased respiratory complications following SSRF. Methods: TQIP (2017-2022) was queried for adult BTPs with multiple rib fractures and\/or flail segment. Male SSRF BTPs were compared to female SSRF BTPs. Multivariable logistic regression analysis was performed to determine if sex was associated with an increased risk of respiratory complications [unplanned intubation, acute respiratory distress syndrome (ARDS), and ventilator-associated pneumonia (VAP)]. Results: The rate of SSRF in males was 3.1% and 2.3% in females (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001). From 20\u2009487 SSRF patients, 15\u2009086 (74%) were male. Both groups had similar median injury severity scores (ISS) of 17; however, males had higher rates of severe thoracic injury (34.7% vs 31.1%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001). Males had higher rates of overall respiratory complications (13.0% vs 10.3%) including ARDS (1.9% vs 1.3%), VAP (3.9% vs 2.4%), and unplanned intubation (7.8% vs 6.8%) (all\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .05). On multivariable analysis, males had an increased risk of respiratory complications (OR 1.37, CI 1.24-1.52,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001) and mortality (OR 1.33, CI 1.07-1.65,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .01). Conclusion: Despite comparable ISS, males more frequently underwent SSRF and had increased risk of respiratory complications and mortality post-operatively. These disparities may reflect underlying anatomical\/physiological factors.\n                  <\/jats:p>","DOI":"10.1177\/00031348251407349","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T08:30:33Z","timestamp":1766046633000},"page":"1876-1882","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-Based Differences in Surgical Stabilization Outcomes for Rib Fractures in Blunt Trauma Patients"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-8539","authenticated-orcid":false,"given":"Negaar","family":"Aryan","sequence":"first","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian Dominik","family":"Schubl","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffry","family":"Nahmias","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Dolich","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lekawa","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9406-4105","authenticated-orcid":false,"given":"Jiabao","family":"Nie","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areg","family":"Grigorian","sequence":"additional","affiliation":[{"name":"University of California Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.09.080"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-23-1832"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111910"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111708"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2023.111276"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.08.022"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111930"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.5090\/jcs.23.095"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.04.99"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003140"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2016-000059"},{"issue":"3","key":"e_1_3_4_13_2","doi-asserted-by":"crossref","first-page":"e001672","DOI":"10.1136\/bmjsem-2023-001672","article-title":"Similarities and differences in skeletal muscle and body composition between sexes: an MRI study of recreational cyclists","volume":"9","author":"Martin Alberto B","year":"2023","unstructured":"Martin Alberto B, Johann H, Anna Di L, Laura Maria H, Alister James H. Similarities and differences in skeletal muscle and body composition between sexes: an MRI study of recreational cyclists. 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