Do all traumatic hemothorax require a tube thoracostomy: A retrospective review
Background: Blunt thoracic trauma accounts for a majority of trauma-related admissions. The Eastern Association for the Surgery of Trauma guidelines recommend placement of a tube thoracostomy for all patients with a hemothorax. Our study was conducted to look at those managed without an intercostal...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Current Research in Scientific Medicine |
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| Online Access: | https://journals.lww.com/10.4103/jcrsm.jcrsm_24_24 |
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| author | Paul Yohan George Vijayan Purushothaman Kirthi Sathyakumar Vignesh Kumar |
| author_facet | Paul Yohan George Vijayan Purushothaman Kirthi Sathyakumar Vignesh Kumar |
| author_sort | Paul Yohan George |
| collection | DOAJ |
| description | Background:
Blunt thoracic trauma accounts for a majority of trauma-related admissions. The Eastern Association for the Surgery of Trauma guidelines recommend placement of a tube thoracostomy for all patients with a hemothorax. Our study was conducted to look at those managed without an intercostal drain (ICD) and the factors that could predict a failure in conservative management.
Materials and Methods:
A retrospective study was conducted from January 2020 to June 2022 at a level-one trauma center in South India to account for patients who required a tube thoracostomy after planned expectant management for hemothorax. All adult patients above 16 years, with traumatic hemothorax were included. Those who had ICD inserted in the emergency department before computed tomography (CT) and those who did not have a CT Thorax were excluded. A retrospective review of patient records was conducted and analyzed using Stata (ver. 16).
Results:
Eighty-eight patients were included in the study, of whom 11 patients required a tube thoracostomy after an initial trial of conservative/expectant management (i.e., not inserting an ICD). The most common reason for failure was an increase in the size of the hemothorax. Among all the predictors we looked at, only a systolic blood pressure of <90 mm Hg on presentation was statistically significant for predicting failure of expectant management.
Conclusion:
Our study suggests not all patients with a traumatic hemothorax require a tube thoracostomy and can be managed expectantly provided close monitoring is possible. An increase in the size of the hemothorax was the main indication for a tube thoracostomy. |
| format | Article |
| id | doaj-art-2c047869999b454599a77f32d5f14be3 |
| institution | Kabale University |
| issn | 2542-6273 2455-3069 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Current Research in Scientific Medicine |
| spelling | doaj-art-2c047869999b454599a77f32d5f14be32025-01-10T14:01:49ZengWolters Kluwer Medknow PublicationsJournal of Current Research in Scientific Medicine2542-62732455-30692024-12-0110216216610.4103/jcrsm.jcrsm_24_24Do all traumatic hemothorax require a tube thoracostomy: A retrospective reviewPaul Yohan GeorgeVijayan PurushothamanKirthi SathyakumarVignesh KumarBackground: Blunt thoracic trauma accounts for a majority of trauma-related admissions. The Eastern Association for the Surgery of Trauma guidelines recommend placement of a tube thoracostomy for all patients with a hemothorax. Our study was conducted to look at those managed without an intercostal drain (ICD) and the factors that could predict a failure in conservative management. Materials and Methods: A retrospective study was conducted from January 2020 to June 2022 at a level-one trauma center in South India to account for patients who required a tube thoracostomy after planned expectant management for hemothorax. All adult patients above 16 years, with traumatic hemothorax were included. Those who had ICD inserted in the emergency department before computed tomography (CT) and those who did not have a CT Thorax were excluded. A retrospective review of patient records was conducted and analyzed using Stata (ver. 16). Results: Eighty-eight patients were included in the study, of whom 11 patients required a tube thoracostomy after an initial trial of conservative/expectant management (i.e., not inserting an ICD). The most common reason for failure was an increase in the size of the hemothorax. Among all the predictors we looked at, only a systolic blood pressure of <90 mm Hg on presentation was statistically significant for predicting failure of expectant management. Conclusion: Our study suggests not all patients with a traumatic hemothorax require a tube thoracostomy and can be managed expectantly provided close monitoring is possible. An increase in the size of the hemothorax was the main indication for a tube thoracostomy.https://journals.lww.com/10.4103/jcrsm.jcrsm_24_24expectant managementhemothoraxintercostal drainagetrauma |
| spellingShingle | Paul Yohan George Vijayan Purushothaman Kirthi Sathyakumar Vignesh Kumar Do all traumatic hemothorax require a tube thoracostomy: A retrospective review Journal of Current Research in Scientific Medicine expectant management hemothorax intercostal drainage trauma |
| title | Do all traumatic hemothorax require a tube thoracostomy: A retrospective review |
| title_full | Do all traumatic hemothorax require a tube thoracostomy: A retrospective review |
| title_fullStr | Do all traumatic hemothorax require a tube thoracostomy: A retrospective review |
| title_full_unstemmed | Do all traumatic hemothorax require a tube thoracostomy: A retrospective review |
| title_short | Do all traumatic hemothorax require a tube thoracostomy: A retrospective review |
| title_sort | do all traumatic hemothorax require a tube thoracostomy a retrospective review |
| topic | expectant management hemothorax intercostal drainage trauma |
| url | https://journals.lww.com/10.4103/jcrsm.jcrsm_24_24 |
| work_keys_str_mv | AT paulyohangeorge doalltraumatichemothoraxrequireatubethoracostomyaretrospectivereview AT vijayanpurushothaman doalltraumatichemothoraxrequireatubethoracostomyaretrospectivereview AT kirthisathyakumar doalltraumatichemothoraxrequireatubethoracostomyaretrospectivereview AT vigneshkumar doalltraumatichemothoraxrequireatubethoracostomyaretrospectivereview |