Multivariate analysis of the effectiveness of the surgical treatment of the non‑flail chest type of multiple rib fractures

The present prospective study aimed to analyze the effectiveness of surgery in treating the non-flail chest type of multiple rib fractures at the multivariate level. For this, patients with non-flail chest type multiple rib fractures were divided into two groups, namely the conservative therapy and surgery groups. Age, sex, the number of fractured and displaced ribs, injury severity, chest abbreviated scores, forced expiratory volume in one second (FEV1), narcotic drug dose, long-term FEV and forced vital capacity levels, drug additive (including pharmacological and individual agents for enhance of physicochemical properties, such as solvent systems), American Society of Anesthesiologists scores, duration of hospitalization, duration until feeling comfortable, follow-up duration, duration until return to workplace, discharge pain score, incidence of pneumothorax and pleural empyema, and pain levels were recorded and analyzed. The results showed that the baseline characteristics were not significantly different between the conservative treatment and surgery groups (P>0.05). In addition, the pain level was notably associated with the FEV1 (r=0.499; P<0.05), drug administration (r=-0.445; P<0.05) and duration of hospitalization (r=0.559; P<0.05) in the conservative treatment group. The discharge pain level was also markedly associated with narcotic drug usage (r=0.478; P<0.05) and drug additive (r=0.618; P<0.01) in the surgery group. Furthermore, the duration of hospitalization significantly affected discharge pain in the conservative group (B=0.237; P<0.01), while drug additive notably affected discharge pain in the surgery group (B=-2.547; P<0.01). Although surgery seemed to be more effective compared with the conservative method in terms of pain management, according to the multivariate analysis results, this effect was associated with the drug additive. Overall, the results of the present study indicated there was no significant difference between surgery and conservative therapy in the treatment of non-flail multiple rib fractures.