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

Authors

Susan Kartiko, From the Department of Surgery (S.K., B.S.), The George Washington University School of Medicine and Health Sciences, Washington, DC; Coalition for National Trauma Research (M.A.P.); Department of Surgery (M.A.P.), University of Texas Health San Antonio, San Antonio, Texas; School of Medicine (D.M.S.), University of Maryland, Baltimore, Maryland; Department of Surgery (J.D.F.), Stanford University, Stanford; Department of Surgery (K.M.), Loma Linda University Health, Loma Linda, California; Department of Surgery (F.M.P.), Denver Health Medical Center, Denver, Colorado; Department of Surgery (A.D.), St. Francis Hospital and Medical Center, Hartford, Connecticut; Department of Surgery (Z.M.B.), University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery (E.E.), Medical University of South Carolina, Charleston, South Carolina; Department of Surgery (F.S.), San Joaquin General Hospital, French Camp, California; Chest Wall Injury Society (S.A.W.); and Department of Surgery (T.W.), Intermountain Medical Center, Murray, Utah.
Michelle A. Price
Deborah M. Stein
Joseph D. Forrester
Kaushik Mukherjee
Fredric M. Pieracci
Andrew Doben
Zachary M. Bauman
Evert Eriksson
Feroze Sidhwa
Sarah Ann Whitbeck
Tom White
Babak Sarani

Document Type

Journal Article

Publication Date

12-17-2025

Journal

The journal of trauma and acute care surgery

DOI

10.1097/TA.0000000000004855

Keywords

NTRAP; chest wall injury; research priorities; rib fractures

Abstract

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: Expert Opinion/Consensus; Level V.

APA Citation

Kartiko, Susan; Price, Michelle A.; Stein, Deborah M.; Forrester, Joseph D.; Mukherjee, Kaushik; Pieracci, Fredric M.; Doben, Andrew; Bauman, Zachary M.; Eriksson, Evert; Sidhwa, Feroze; Whitbeck, Sarah Ann; White, Tom; and Sarani, Babak, "Research priorities in chest wall injury: Secondary analysis of the National Trauma Research Action Plan" (2025). GW Authored Works. Paper 8393.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8393

Department

Surgery