We conducted a retrospective review of real-world data from routine care of all the patients admitted in a Level I trauma center (Centre Hospitalo-Universitaire des Hospices Civiles de Lyon, France) with severe thoracic trauma who underwent SSRF from September 2010 to January 2020. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study received Institutional Review Board approval from the French Society of Thoracic and Cardio-Vascular Surgery (Société Française de Chirurgie Thoracique et Cardio-Vasculaire – IRB00012919 – 05/04/2022) and informed consent was taken from all the patients.
Severe thoracic trauma was defined by an Abbreviated Injury Scale (AIS) of 3 or more (16 (link)). All selected patients had 3 or more displaced rib fractures or flail chest [as defined per the taxonomy of Edwards et al. (17 (link))], a respiratory rate >25 cycles/min or hypoxemia on pulse oximetry (<90% without oxygen) or a circulatory failure (systolic arterial pressure <110 mmHg, or more than 30% decrease in systolic arterial pressure). On admission, full body CT scan (Figure 1) screened all patients with severe thoracic trauma without severe hemodynamic instability or life-threatening injury. Patients were managed according to the guidelines of the French society of critical care and anesthesia (18 (link)). All life threatening or hemorrhagic lesions were treated before SSRF.