{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:09:16Z","timestamp":1793045356543,"version":"4.5.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"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":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most studies demonstrating efficacy of surgical stabilization of rib fractures (SSRF) are in patients with isolated severe chest wall injury. Recent evidence suggests SSRF may reduce mortality in polytrauma patients. The present study examines SSRF outcomes in severe polytrauma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2013-2021 Trauma Quality Improvement Project database was used to identify severe polytrauma patients, defined as Injury Severity Score (ISS) \u226515 and abbreviated injury scale (AIS) \u22652 in 2 or more regions, with rib fractures. Exclusion criteria included AIS 6 in any region, death \u226472 hours, or SSRF &gt;72 hours after admission. Outcomes of interest were in-hospital mortality, pneumonia, acute respiratory distress syndrome (ARDS), and length of mechanical ventilation. Adjustment for confounding was achieved using inverse probability of treatment weighting, Poisson regression models and quantile regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 388\u00a0091 patients met inclusion criteria, of which 1.3% (N = 5020) underwent SSRF. SSRF was associated with a 57% decreased risk of mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and 53% lower risk of ARDS (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Patients who underwent SSRF also required approximately 1 day less of mechanical ventilation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Patients with ISS 15-19 exhibited an association between SSRF and a 55% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.023) lower rate of pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SSRF within 72 hours of admission in severe polytrauma patients is associated with a lower rate of mortality and acute respiratory distress syndrome, along with shorter duration of mechanical ventilation. A reduction in the rate of pneumonia was only observed among patients with ISS 15-19.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261421661","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:12:24Z","timestamp":1770768744000},"page":"2169-2179","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Stabilization of Rib Fractures in Severe Polytrauma: A Potential Indication"],"prefix":"10.1177","volume":"92","author":[{"given":"Mary","family":"Matecki","sequence":"first","affiliation":[{"name":"George Washington University"}],"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":"Orebro University Hospital"},{"name":"Orebro University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-9153","authenticated-orcid":false,"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"Orebro University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-3004","authenticated-orcid":false,"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":"Orebro University"},{"name":"New Jahra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-022-02200-w"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2022.05.001"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000453"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.024"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002559"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2018-000288"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002994"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01179-1"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-021-01864-0"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-21-649"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-017-3612-1"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003790"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.12.010"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004338"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-024-00540-z"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003828"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002716"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-20-2"},{"key":"e_1_3_6_20_2","first-page":"136","article-title":"Polytrauma in the elderly","volume":"318","author":"Lonner JH","year":"1995","unstructured":"Lonner JH, Koval KJ. Polytrauma in the elderly. Clin Orthop Relat Res. 1995;318:136-143.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000037095.83469.4C"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-018-0969-9"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261421661","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261421661","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261421661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T07:00:18Z","timestamp":1782370818000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261421661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/00031348261421661"],"URL":"https:\/\/doi.org\/10.1177\/00031348261421661","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]}}}