The efficacy and safety of conservative treatment versus surgery for traumatic flail chest in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To compare the clinical safety and efficacy of conservative treatment and surgery for traumatic flail chest in elderly patients.Methods From January 2013 to January 2017,68 elderly patients with traumatic flail chest in the Department of Thoracic Surgery,Beijing Lu He Hospital were enrolled.Based on different treatment methods,patients were divided into a conservative treatment group (n =34) and a surgery group (n =34),and the clinical safety and efficacy were compared between the two different treatment groups.Results Patients in the surgery group were associated with significantly decreased mechanical ventilation time,and days stayed in ICU and hospital,compared with the conservative treatment group (all P＜0.05).However,incidences of atelectasis and/or pneumonia,duration of pain and oxygen therapy,total thoracic drainage volume and extubation time were similar between the two groups (all P＞0.05).Rates of delayed or nonunion (2.9％ vs.17.6％) and thoracic deformity (0.0％ vs.11.8％) were significantly lower in the surgery group than those in the conservative treatment group (x2=3.981 and 4.250,both P＜0.05).Conclusions Surgery can safely and effectively reduce incidences of complications in elderly patients with traumatic flail chest disease and shorten the time of hospitalization.Therefore,the short-and longterm effects are promising and warrant further investigation.