Table 4.
Results of individual reviews that report a meta-analysis for flail chest
| Total length of invasive mechanical ventilation (days) | ||||||
| Studies reporting outcome | No of studies (no of participants in analysis) | Study types | Details of meta-analysis | Results | I2 | |
| RCT | NR | |||||
| Cataneo et al 20 | 3 (123) | 3 | 0 | MD (IV, fixed, 95% CI) | Results not pooled | – |
| Coughlin et al 19 | 3 (123) | 3 | 0 | MD (IV, random, 95% CI) | −6.30 (−12.16 to –0.43) | 95 |
| Leinicke et al 22 | 8 (474) | 2 | 6 | MD (IV, random 95% CI) | −4.52 (−5.54 to –3.50) | 48.6 |
| Schuurmans et al 18 | 3 (123) | 3 | 0 | MD (IV, random, 95% CI) | −6.53 (−11.88 to –1.18) | 93 |
| Slobogean et al 21 | 8 Studies (563) | 2 | 6 | MD (IV, fixed, 95% CI) | −7.5 (−9.9 to –5.0) | 48 |
| Swart et al 17 | 18 Studies (1150) | 3 | 15 | MD (IV, random, SD) | −4.57 (0.59) | 83 |
| Mortality (frequency) | ||||||
| Cataneo et al 20 | 3 (123) | 3 | 0 | RR (M-H, fixed, 95% CI) | 0.56 (0.13 to 2.42) | 0 |
| Coughlin et al 19 | 2 (86) | 2 | 0 | RR (M-H, random, 95% CI) | 0.57 (0.13 to 2.52) | 0 |
| Leinicke et al 22 | 5 (343) | 1 | 0 | RR (95% CI) | 0.43 (0.28 to 0.69) | 0 |
| Schuurmans et al 18 | 2 (86) | 2 | 0 | RR (M-H, fixed, 95% CI) | 0.56 (0.13 to 2.42) | 0 |
| Slobogean et al 21 | 7 (582) | 2 | 5 | OR (M-H, fixed, 95% CI) | 0.31 (0.20 to 0.48) | – |
| Slobogean et al 21 | 7 (582) | 2 | 5 | RR (M-H, fixed, 95% CI) | 0.19 (0.13 to 0.26) | 0 |
| Swart et al 17 | 13 (1263) | 3 | 10 | RR (M-H, random, SD) | 0.44 (0.09) | 0 |
| Total length of stay in intensive care unit (days) | ||||||
| Cataneo et al 20 | 2 (77) | 2 | 0 | MD (IV, fixed, 95% CI) | Results not pooled | – |
| Coughlin et al 19 | 3 (123) | 3 | 0 | MD (IV, random, 95% CI) | −6.46 (−9.73 to –3.19) | 35 |
| Leinicke et al 22 | 5 (235) | 2 | 3 | MD (IV, random, 95% CI) | −3.4 (−6.01 to –0.80) | 74.9 |
| Schuurmans et al 18 | 3 (123) | 3 | 0 | MD (IV, fixed, 95% CI) | −5.18 (−6.17 to –4.19) | 40 |
| Slobogean et al 21 | 4 (261) | 2 | 2 | MD (IV, fixed, 95% CI) | −4.8 (−7.9 to –1.6) | 0.1 |
| Swart et al 17 | 14 (840) | 3 | 11 | MD (IV, random, SD) | −3.25 (1.29) | 91 |
| Total length of stay in hospital (days) | ||||||
| Coughlin et al 19 | 2 (86) | 2 | 0 | MD (IV, random, 95% CI) | −11.39 (−12.39 to –10.38) | 0 |
| Leinicke et al 22 | 5 (262) | 1 | 4 | MD (IV, random 95% CI) | −3.83 (−7.12 to –0.54) | 68.9 |
| Schuurmans et al 18 | 2 (86) | 2 | 0 | MD (IV, fixed, 95% CI) | −11.39 (−12.39 to –10.38) | 0 |
| Slobogean et al 21 | 4 (404) | 1 | 3 | MD (IV, fixed, 95% CI) | −4.0 (−7.4 to –0.7) | 33 |
| Swart et al 17 | 11(438) | 1 | 10 | MD (IV, random, SD) | −4.48 (1.98) | 89 |
| Pneumonia (frequency) | ||||||
| Cataneo et al 20 | 3 (123) | 3 | 0 | RR (M-H, random, 95% CI) | 0.36 (0.15 to 0.85) | 66 |
| Coughlin et al 19 | 3 (123) | 3 | 0 | RR (M-H, random, 95% CI) | 0.36 (0.15 to 0.85) | 66 |
| Leinicke et al 22 | 4 (260) | 1 | 3 | RR (95% CI) | 0.43 (0.28 to 0.69) | 31 |
| Schuurmans et al 18 | 2 (83) | 2 | 0 | RR (M-H, fixed, 95% CI) | 0.45 (0.29 to 0.7) | 74 |
| Slobogean et al 21 | 8 (816) | 2 | 6 | OR (M-H, fixed, 95% CI) | 0.18 (0.11 to 0.32) | 4 |
| Slobogean et al 21 | 8 (816) | 2 | 6 | RR (M-H, fixed, 95% CI) | 0.31 (0.21 to 0.41) | 4 |
| Swart et al 17 | 15 (1005) | 3 | 12 | RR (M-H, random, SD) | 0.59 (0.10) | 55 |
| Tracheostomy (frequency) | ||||||
| Cataneo et al 20 | 2 (83) | 2 | 0 | RR (M-H, random, 95% CI) | 0.38 (0.14 to 1.02) | 64 |
| Leinicke et al 22 | 4 (215) | 1 | 3 | RR (95% CI) | 0.25 (0.13 to 0.47) | 0 |
| Schuurmans et al 18 | 2 (83) | 2 | 0 | RR (M-H, fixed, 95% CI) | 0.4 (0.2 to 0.7) | Not reported |
| Slobogean et al 21 | 3 (165) | 1 | 2 | OR (M-H, fixed, 95% CI) | 0.12 (0.04 to 0.32) | 0 |
| Slobogean et al 21 | 3 (165) | 1 | 2 | RR (M-H, fixed, 95% CI) | 0.34 (0.10 to 0.57) | 0 |
| Swart et al 17 | 11 (975) | 2 | 9 | RR (M-H, random, SD) | 0.52 (0.07) | 42 |
| Sepsis (frequency) | ||||||
| Slobogean et al 21 | 4 (345) | 0 | 4 | OR (M-H, fixed, 95% CI) | 0.36 (0.19 to 0.71) | 0 |
| Slobogean et al 21 | 4 (345) | 0 | 4 | RR (M-H, fixed, 95% CI) | 0.14 (0.56 to 0.23) | 0 |
| Spirometry (percentage of predicated) | ||||||
| Coughlin et al 19 | – | – | – | – | – | – |
| FVC | 2 (74) | 2 | 0 | MD (IV, random, 95% CI) p value | 1.53 (−13.49 to 16.55) p=0.84 | Not reported |
| FEV1 | 2 (74) | 2 | 0 | MD (IV, random, 95% CI) p value | −0.42 (−4.83 to 3.98) p=0.85 | Not reported |
| TLC | 2 (74) | 2 | 0 | MD (IV, random, 95% CI) p value | 3.69 (−3.08 to 10.46) p=0.29 | Not reported |
| PEFR | 2 (74) | 2 | 0 | MD (IV, random, 95% CI) p value | 0.38 (−0.76 to 1.53) p=0.51 | Not reported |
| Chest deformity (frequency) | ||||||
| Cataneo et al 20 | 2 (86) | 2 | 0 | RR (M-H, fixed, 95% CI) | 0.13 (0.03 to 0.67) | 0 |
| Slobogean et al 21 | 4 (228) | 1 | 3 | OR (M-H, fixed, 95% CI) | 0.11 (0.02 to 0.60) | 2.1 |
| Slobogean et al 21 | 4 (228) | 1 | 3 | RR (M-H, fixed, 95% CI) | 0.30 (0.00 to 0.60) | 2.1 |
| Dyspnoea (frequency) | ||||||
| Slobogean et al 21 | 3 (135) | 1 | 2 | OR (M-H, fixed, 95% CI) | 0.40 (0.16 to 1.01) | 0 |
| Slobogean et al 21 | 3 (135) | 1 | 2 | RR (M-H, fixed, 95% CI) | 0.15 (0.09 to 0.39) | 0 |
| Chest pain (frequency) | ||||||
| Slobogean et al 21 | 2 (71) | 1 | 1 | OR (M-H, fixed, 95% CI) | 0.40 (0.01 to 12.60) | 0 |
| Slobogean et al 21 | 2 (71) | 1 | 1 | RR (M-H, fixed, 95% CI) | 0.18 (-0.46 to 0.83) | 0 |
FEV1, forced expiratory volume; FVC, force vital capacity; IV, inverse variance; M-H, Mantel-Haenszel; MD, mean difference; NR, non-randomised study; PEFR, peak expiratory flow rate; RCT, randomised controlled trial; RR, risk ratio; TLC, total lung capacity.