Rapid sequence versus early surgical stabilization of severe chest wall injuries: a propensity score-matched analysis from a multicenter trauma registry
Authors' conclusion
In this large registry analysis, rapid sequence CWR on the day of admission identified a distinct subgroup of patients with more severe concomitant injuries and higher baseline risk. The higher mortality in this group likely reflects residual confounding by indication and survivorship bias, rather than a detrimental effect of rapid surgery per se.
Study context
- Population
- Severely injured patients with serious chest wall injuries (AISThorax ≥3), Injury Severity Score (ISS) ≥ 9, surviving first 48 h and undergoing Chest Wall Reconstruction (CWR), TraumaRegister DGU® 2015–2023
- Participants
- 2,498 participants · 500 matched pairs
- Exposure
- Rapid sequence surgery vs early surgery for chest wall reconstruction
- Rapid Sequencen = 1,168
- Earlyn = 567reference
- Outcome
- In-hospital mortality
Methodological detailspropensity-score matched, multicentre registry
- Propensity-score matched
- Multicentre registry
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Secondary outcomes
In-hospital mortality before matching · unmatched cohort
In-hospital mortality before matching
- Significantly higher mortality in the Rapid Sequence group before matching
Sepsis
- Higher in the rapid group, not statistically significant
- Propensity-matched cohort
Multi-organ failure (MOF)
- Higher in the rapid group, not statistically significant
- Propensity-matched cohort
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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