Research priorities in chest wall injury: Secondary analysis of the National Trauma Research Action Plan

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INTRODUCTION: Chest wall injury (CWI) occurs in 10% to 15% of trauma admissions and is associated with significant short- and long-term morbidity. Despite recent advances in management, critical knowledge gaps remain. This study sought to identify consensus-based research priorities for CWI established by the National Trauma Research Action Plan (NTRAP). METHODS: This study is a secondary analysis of consensus-based research priorities collected using an online Delphi survey methodology by 11 NTRAP panels, each focused on different domains across the entire spectrum of trauma care. The database of research questions or gaps was queried for the key words "Chest Wall/Rib," "Rib Fracture/Pain Management," and "Rib Fracture/Pulmonary Management." RESULTS: Fifty-seven CWI-related research questions were identified across seven NTRAP panels. Of these, 15 (26%) were rated as high priority and 42 (74%) as medium priority. Most CWI-related research questions appeared in the following topics: Chest Wall/Ribs (n = 22), followed by Blocks/Regional Anesthesia: Effects on Pain (acute/chronic, hemodynamics, inflammation) (n = 5) and Special Populations: Long-term Outcomes after Trauma in Older Adults; Functional Recovery and Mortality (n = 3). Eighteen questions specifically addressed surgical rib fixation. CONCLUSION: National Trauma Research Action Plan identified 57 consensus-driven research priorities in CWI. These findings should inform extramural funding efforts, focusing on studies that evaluate short-term clinical metrics, comparative effectiveness research between surgical and nonsurgical management, and the long-term impact of CWI on patient recovery and quality of life. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level V.

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