Clinical value of surgical intervention and decision-making dilemmas for elderly patients of rib fractures: a systematic review and meta-analysis

Background: For elderly patients, when weighing the benefits and risks associated with surgery, the treatment strategy remains controversial. Our objective was to compare clinical outcomes between surgical and non-surgical management of rib fractures in patients aged ≥60 years. Methods: PubMed, Embase, Cochrane Library, and Web of Science were searched for studies comparing surgical intervention with non-surgical treatment in elderly patients of rib fractures over the past decade. The mean differences (MDs) for continuous outcomes, the risk ratios (RRs) for binary outcomes, and the 95% confidence intervals (CIs) were calculated. Meta-analysis was performed using Review Manager (RevMan) version 5.4. Results: Ten studies were included with a total of 98,004 patients, of whom 2,478 underwent surgical intervention. Compared with non-surgical treatment, surgical intervention was associated with lower mortality (RR =0.61, 95% CI: 0.49, 0.75, P