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Table 4 Thoracic injuries, estimated CT-lung volume, and lung function 6 weeks, 6 months and one year post-trauma in patients managed operatively (Op group) with or without a thoracotomy, and non-operatively (Non-Op group) for flail chest injuries

From: A bi-institutional observational study comparing short-term and long-term outcome of operative and non-operative management of clinical and radiological flail chest injuries

Follow-up

Variable

Op group

Non-Op group

  

All

(n = 48)

 + Thoracotomy

(n = 34)

-Thoracotomy

(n = 14)

(n = 35)

Initial CT

CT Lung volume (l)

2.72 (1.30–5.31)

2.56 (1.43–4.69)

3.31 (1.30–5.31)

2.92 (1.69–6.97)

Pneumothorax (n, %)

33 (69)

25 (74)

8 (57)

29 (83)

Pneumothorax volume (l)

0.22 (0.01–1.02)

0.13 (0.01–0.62)

0.76 (0.50–1.02)

0.11 (0.02–0.62)

Bilat Flail chest (n, %)

5 (10)

4 (12)

1 (7)

2 (6)

Hemothorax (n, %)

42 (88)

30 (88)

12 (86)

27 (77)

Lung contusion (n, %)

33 (69)

24 (71)

9 (64)

24 (69)

Lung laceration (n, %)

8 (17)

5 (15)

3 (21)

10 (29)

6 weeks

Predicted FVC (%)

84 (47–125)

78 (47–99)a,b

92 (54–125)

89 (47–111)

Predicted FEV1 (%)

76 (42–140)a

67 (42–95)a,b

92 (59–140)

84 (39–113)

Predicted PEF (%)

88 (42–142)

82 (47–132)b

103 (42–142)

101 (27–134)

MIP (cm H20)

70 ± 29a

64 ± 28a,b

84 ± 28

87 ± 27

MEP (cm H20)

98 ± 35a

94 ± 29a

106 ± 47

130 ± 37

6 months

CT Lung volume (l)

5.61 (2.11–8.77)

5.30 (2.11–7.40)b

6.60 (3.87–8.77)

5.80 (1.82–8.04)

Predicted FVC (%)

88 (41–138)

83 (41–112)b

96 (70–138)

94 (47–118)

Predicted FEV1 (%)

81 (39–120)a

75 (39–103)a,b

96 (69–120)

94 (45–131)

Predicted PEF (%)

89 (41–148)a

81 (41–148)a,b

97 (41–131)

100 (33–150)

MIP (cm H20)

78 ± 36a

74 ± 37a

89 ± 35

104 ± 28

MEP (cm H20)

107 ± 39a

104 ± 39a

114 ± 42a

155 ± 49

1 year

Predicted FVC (%)

90 (49–138)

82 (49–115)

97 (76–138)

96 (48–118)

Predicted FEV1 (%)

82 (39–126)a

75 (39–108)a,b

96 (72–126)

96 (41–123)

Predicted PEF (%)

98 (43–134)

93 (43–134)

107 (70–129)

108 (25–155)

MIP (cm H20)

82 ± 31a

78 ± 28a

95 ± 37

106 ± 29

MEP (cm H20)

110 ± 39a

108 ± 38a

116 ± 44a

158 ± 43

  1. Continuous variables are shown as mean with SD and compared with T-test or shown as median with range and compared with Mann–Whitney U test
  2. CT Computed Tomography, FVC Forced Vital Capacity, FEV1 Forced Expiratory Volume in 1 s, PEF Peak Expiratory Flow, MIP Maximal Inspiratory Pressure, MEP Maximal Expiratory Pressure
  3. aDifference between Op group and Non-Op group (p < 0.05)
  4. bDifference within Op group with and without thoracotomy (p < 0.05)