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Surgical versus nonsurgical interventions for flail chest

Overview of attention for article published in Cochrane database of systematic reviews, July 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (84th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

1 blog
5 tweeters
1 Facebook page


46 Dimensions

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118 Mendeley
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Surgical versus nonsurgical interventions for flail chest
Published in
Cochrane database of systematic reviews, July 2015
DOI 10.1002/14651858.cd009919.pub2
Pubmed ID

Antonio José Maria Cataneo, Daniele C Cataneo, Frederico HS de Oliveira, Karine A Arruda, Regina El Dib, Paulo Eduardo de Oliveira Carvalho


Thoracic trauma (TT) is common among people with multiple traumatic injuries. One of the injuries caused by TT is the loss of thoracic stability resulting from multiple fractures of the rib cage, otherwise known as flail chest (FC). A person with FC can be treated conservatively with orotracheal intubation and mechanical ventilation (internal pneumatic stabilization) but may also undergo surgery to fix the costal fractures. To evaluate the effectiveness and safety of surgical stabilization compared with clinical management for people with FC. We ran the search on the 12 May 2014. We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (OvidSP), EMBASE Classic and EMBASE (OvidSP), CINAHL Plus (EBSCO), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), and clinical trials registers. We also screened reference lists and contacted experts. Randomized controlled trials of surgical versus nonsurgical treatment for people diagnosed with FC. Two review authors selected relevant trials, assessed their risk of bias, and extracted data. We included three studies that involved 123 people. The methods used for blinding the participants and researchers to the treatment group were not reported, but as the comparison is surgical treatment with medical treatment this bias is hard to avoid. There was no description of concealment of the randomization sequence in two studies.All three studies reported on mortality, and deaths occurred in two studies. There was no clear evidence of a difference in mortality between treatment groups (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.13 to 2.42); however, the analysis was underpowered to detect a difference between groups. Out of the 123 people randomized and treated, six people died; the causes of death were pneumonia, pulmonary embolism, mediastinitis, and septic shock.Among people randomized to surgery, there were reductions in pneumonia (RR 0.36, 95% 0.15 to 0.85; three studies, 123 participants), chest deformity (RR 0.13, 95% CI 0.03 to 0.67; two studies, 86 participants), and tracheostomy (RR 0.38, 95% CI 0.14 to 1.02; two studies, 83 participants). Duration of mechanical ventilation, length of intensive care unit stay (ICU), and length of hospital stay were measured in the three studies. Due to differences in reporting, we could not combine the results and have listed them separately. Chest pain, chest tightness, bodily pain, and adverse effects were each measured in one study. There was some evidence from three small studies that showed surgical treatment was preferable to nonsurgical management in reducing pneumonia, chest deformity, tracheostomy, duration of mechanical ventilation, and length of ICU stay. Further well-designed studies with a sufficient sample size are required to confirm these results and to detect possible surgical effects on mortality.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 118 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Unknown 117 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 20 17%
Student > Master 19 16%
Researcher 16 14%
Student > Ph. D. Student 9 8%
Student > Doctoral Student 8 7%
Other 23 19%
Unknown 23 19%
Readers by discipline Count As %
Medicine and Dentistry 62 53%
Nursing and Health Professions 9 8%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Biochemistry, Genetics and Molecular Biology 3 3%
Agricultural and Biological Sciences 3 3%
Other 7 6%
Unknown 31 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 May 2016.
All research outputs
of 15,641,217 outputs
Outputs from Cochrane database of systematic reviews
of 11,229 outputs
Outputs of similar age
of 235,726 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 257 outputs
Altmetric has tracked 15,641,217 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,229 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.3. This one has gotten more attention than average, scoring higher than 58% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 235,726 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 257 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.