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Table 4 Factors associated with postoperative complications

From: Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center

Variable

No postoperative complication, n = 24

Postoperative complication, n = 18

OR [CI 95%]

p

Demographics

 Age (years), median IQR [25–75]

52.4 [37.4–73.8]

69.01 [54.8–79.6]

 

0.09

 Sex (M, F)

18.6

10.8

0.42 [0.11–1.62]

0.19

 Charlson score, median IQR [25–75]

0 [0–1]

1 [0–2]

 

0.03

 Active smoking, n (%)

12 (50)

5 (28)

0.38 [0.099–1.49]

0.15

Characteristics of trauma

 Road traffic accidents, n (%)

12 (50)

8 (44)

0.80 [0.23–2.77]

0.72

 Domestic fall, n (%)

9 (38)

8 (44)

1.33 [0.38–4.71]

0.65

 Time from trauma to ICU referral (days), median [IQR 25–75]

2 [1–6]

1.5 [0–3]

 

0.34

 TTSS, median [IQR 25–75]

10 [8–11]

12 [11–14.75]

 

0.0005

 Bilateral thoracic trauma, n (%)

2 (8)

8 (44)

8.80 [1.29–59.92]

0.007

 Other chest fractures, n (%)

7 (29)

13 (72)

5.20 [1.15–23.53]

0.017

 Number of broken ribs, median IQR [25–75]

6.5 [5–7.25]

8 [5.25–11.5]

 

0.086

 Extra-thoracic trauma

10 (42)

7 (38)

0.89 [0.25–3.15]

0.86

Severity factors at initial management

 ISS, median IQR [25–75]

41.5 [16–29]

26 [16–27]

 

0.59

 SAPSII, median IQR [25–75]

19 [15–26]

33 [30–38]

 

0.0001

 SAPSII without age, median IQR [25–75]

10 [7–17.5]

20 [14–25]

 

0.001

 Respiratory failure, n (%)*

3 (13)

9 (50)

7.00 [1.29–37.93]

0.008

Peroperative management

 Time from trauma to surgery (days), median [IQR 25–75]

4.5 [2–7.25]

3 [1–6]

 

0.24

 Duration of surgery (minutes), median [IQR 25–75]

125 [120–150]

150 [120–180]

 

0.11

 Transfusion of red blood cells, n (%)

1 (4)

5 (28)

8.85 [0.79–99.31]

0.03

 Number of red blood cells, median IQR [25–75]

0 [0–0]

0 [0–2]

 

0.004

 Vasopressor support, n (%)

4 (9)

7 (17)

2.86 [0.64–12.81]

0.15

 Loco regional analgesia

24 (100)

16 (88)

 

0.09

Postoperative support and outcomes

 Mechanical ventilation duration (days), median IQR [25–75]

0 [0–0]

3.5 [0–8.0]

 

0.0004

 ICU length of stay, median IQR [25–75]

5 [3.75–7]

9 [6.25–17.5]

 

0.0002

 In-ICU mortality, n (%)

0 (0)

2 (11)

 

0.9

 Hospital length of stay, median IQR [25–75]

10 [7–12.25]

17 [11.25–31.5]

 

0.0002

  1. COPD, Chronic Obstructive Pulmonary Disease; TTSS, Thoracic Trauma Severity Score; SAPSII, Simplified Acute Physiology Score; ISS, Index Severity Score; ICU, Intensive Care Unit
  2. *Respiratory failure: need for high flow nasal oxygen (HFNO), non-invasive ventilation (NIV), or intubation with invasive ventilation