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Chest tube output, duration, and length of stay are similar for pneumothorax and hemothorax seen only on computed tomography vs. chest radiograph.

Abstract

PURPOSE

Whole-body computed tomography (CT) for blunt trauma patients is common. Chest CT (CCT) identifies "occult" pneumo- (PTX) and hemothorax (HTX) not seen on chest radiograph (CXR), one-third of whom get chest tubes, while CXR identifies "non-occult" PTX/HTX. To assess chest tube value for occult injury vs. expectant management, we compared output, duration, and length of stay (LOS) for chest tubes placed for occult vs. non-occult (CXR-visible) injury.

METHODS

We compared chest tube output and duration, and patient length of stay for occult vs. non-occult PTX/HTX. This was a retrospective analysis of 5451 consecutive Level I blunt trauma patients, from 2010 to 2013.

RESULTS

Of these blunt trauma patients, 402 patients (7.4%) had PTX, HTX or both, and both CXR and CCT. One third (n = 136, 33.8%) had chest tubes placed in 163 hemithoraces (27 bilateral). Non-occult chest tube output for all patients was 1558 ± 1919 cc (n = 54), similar to occult at 1123 ± 1076 cc (n = 109, p = 0.126). Outputs were similar for HTX-only patients, with non-occult (n = 34) at 1917 ± 2130 cc, vs. occult (n = 54) at 1449 ± 1131 cc (p = 0.24). Chest tube duration for all patients was 6.3 ± 4.9 days for non-occult vs. 5.0 ± 3.3 for occult (p = 0.096). LOS was similar between all occult injury patients (n = 46) and non-occult (n = 90, 17.0 ± 15.8 vs. 13.7 ± 11.9 days, p = 0.23).

CONCLUSION

Mature clinical judgment may dictate which patients need chest tubes and explain the similarity between groups.

Authors+Show Affiliations

University of California, Irvine, Irvine, CA, USA.University of California, Irvine, Irvine, CA, USA.University of California, Irvine, Irvine, CA, USA.University of California, Irvine, Irvine, CA, USA.University of California, San Francisco, San Francisco, CA, USA.University of California, Irvine, Irvine, CA, USA. milangdo@uci.edu. Department of Emergency Medicine, University of California, Irvine, 333 City Blvd. West, Suite 640, Orange, CA, 92868, USA. milangdo@uci.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31384999

Citation

Patel, Bhavesh H., et al. "Chest Tube Output, Duration, and Length of Stay Are Similar for Pneumothorax and Hemothorax Seen Only On Computed Tomography Vs. Chest Radiograph." European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, 2019.
Patel BH, Lew CO, Dall T, et al. Chest tube output, duration, and length of stay are similar for pneumothorax and hemothorax seen only on computed tomography vs. chest radiograph. Eur J Trauma Emerg Surg. 2019.
Patel, B. H., Lew, C. O., Dall, T., Anderson, C. L., Rodriguez, R., & Langdorf, M. I. (2019). Chest tube output, duration, and length of stay are similar for pneumothorax and hemothorax seen only on computed tomography vs. chest radiograph. European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, doi:10.1007/s00068-019-01198-y.
Patel BH, et al. Chest Tube Output, Duration, and Length of Stay Are Similar for Pneumothorax and Hemothorax Seen Only On Computed Tomography Vs. Chest Radiograph. Eur J Trauma Emerg Surg. 2019 Aug 5; PubMed PMID: 31384999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest tube output, duration, and length of stay are similar for pneumothorax and hemothorax seen only on computed tomography vs. chest radiograph. AU - Patel,Bhavesh H, AU - Lew,Christopher O, AU - Dall,Tanya, AU - Anderson,Craig L, AU - Rodriguez,Robert, AU - Langdorf,Mark I, Y1 - 2019/08/05/ PY - 2019/03/16/received PY - 2019/07/26/accepted PY - 2019/8/7/entrez KW - Computed tomography KW - Thoracic KW - Trauma KW - Tube thoracostomy JF - European journal of trauma and emergency surgery : official publication of the European Trauma Society JO - Eur J Trauma Emerg Surg N2 - PURPOSE: Whole-body computed tomography (CT) for blunt trauma patients is common. Chest CT (CCT) identifies "occult" pneumo- (PTX) and hemothorax (HTX) not seen on chest radiograph (CXR), one-third of whom get chest tubes, while CXR identifies "non-occult" PTX/HTX. To assess chest tube value for occult injury vs. expectant management, we compared output, duration, and length of stay (LOS) for chest tubes placed for occult vs. non-occult (CXR-visible) injury. METHODS: We compared chest tube output and duration, and patient length of stay for occult vs. non-occult PTX/HTX. This was a retrospective analysis of 5451 consecutive Level I blunt trauma patients, from 2010 to 2013. RESULTS: Of these blunt trauma patients, 402 patients (7.4%) had PTX, HTX or both, and both CXR and CCT. One third (n = 136, 33.8%) had chest tubes placed in 163 hemithoraces (27 bilateral). Non-occult chest tube output for all patients was 1558 ± 1919 cc (n = 54), similar to occult at 1123 ± 1076 cc (n = 109, p = 0.126). Outputs were similar for HTX-only patients, with non-occult (n = 34) at 1917 ± 2130 cc, vs. occult (n = 54) at 1449 ± 1131 cc (p = 0.24). Chest tube duration for all patients was 6.3 ± 4.9 days for non-occult vs. 5.0 ± 3.3 for occult (p = 0.096). LOS was similar between all occult injury patients (n = 46) and non-occult (n = 90, 17.0 ± 15.8 vs. 13.7 ± 11.9 days, p = 0.23). CONCLUSION: Mature clinical judgment may dictate which patients need chest tubes and explain the similarity between groups. SN - 1863-9941 UR - https://www.unboundmedicine.com/medline/citation/31384999/Chest_tube_output,_duration,_and_length_of_stay_are_similar_for_pneumothorax_and_hemothorax_seen_only_on_computed_tomography_vs._chest_radiograph L2 - https://dx.doi.org/10.1007/s00068-019-01198-y DB - PRIME DP - Unbound Medicine ER -