Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax
Background. An occult pneumothorax is identified by computed tomography but not visualized by a plain film chest X-ray. The optimal management remains unclear. Methods. A retrospective review of an urban level I trauma center’s trauma registry was conducted to identify patients with occult pneumotho...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/9274697 |
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| author | Michael Paplawski Swapna Munnangi Jody C. Digiacomo Edwin Gonzalez Ashley Modica Shawndeep S. Tung Catherine Ko |
| author_facet | Michael Paplawski Swapna Munnangi Jody C. Digiacomo Edwin Gonzalez Ashley Modica Shawndeep S. Tung Catherine Ko |
| author_sort | Michael Paplawski |
| collection | DOAJ |
| description | Background. An occult pneumothorax is identified by computed tomography but not visualized by a plain film chest X-ray. The optimal management remains unclear. Methods. A retrospective review of an urban level I trauma center’s trauma registry was conducted to identify patients with occult pneumothorax over a 2-year period. Factors predictive of chest tube placement were identified using univariate and multivariate logistic regression analysis. Results. A total of 131 patients were identified, of whom 100 were managed expectantly with an initial period of observation. Ultimately, 42 (32.0%) patients received chest tubes and 89 did not. The patients who received chest tubes had larger pneumothoraces at initial assessment, a higher incidence of rib fractures, and an increased average number of rib fractures, of which significantly more were displaced. Conclusions. Displaced rib fractures and moderate-sized pneumothoraces are significant factors associated with chest tube placement in a victim of blunt trauma with occult pneumothorax. The optimal timing for the first follow-up chest X-ray remains unclear. |
| format | Article |
| id | doaj-art-483bcf0318704046884bce2ea795c39a |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-483bcf0318704046884bce2ea795c39a2025-08-20T03:36:07ZengWileyCritical Care Research and Practice2090-13052090-13132019-01-01201910.1155/2019/92746979274697Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult PneumothoraxMichael Paplawski0Swapna Munnangi1Jody C. Digiacomo2Edwin Gonzalez3Ashley Modica4Shawndeep S. Tung5Catherine Ko6Department of Surgery, Nassau University Medical Center, East Meadow, NY, USADepartment of Surgery, Nassau University Medical Center, East Meadow, NY, USADepartment of Surgery, Nassau University Medical Center, East Meadow, NY, USADepartment of Surgery, Nassau University Medical Center, East Meadow, NY, USADepartment of Plastic Surgery, University of South Florida Morsani School of Medicine, Tampa, FL, USABanner MD Anderson Cancer Center, Sun City West, AZ, USADoctors Center, Bridgeport, CT, USABackground. An occult pneumothorax is identified by computed tomography but not visualized by a plain film chest X-ray. The optimal management remains unclear. Methods. A retrospective review of an urban level I trauma center’s trauma registry was conducted to identify patients with occult pneumothorax over a 2-year period. Factors predictive of chest tube placement were identified using univariate and multivariate logistic regression analysis. Results. A total of 131 patients were identified, of whom 100 were managed expectantly with an initial period of observation. Ultimately, 42 (32.0%) patients received chest tubes and 89 did not. The patients who received chest tubes had larger pneumothoraces at initial assessment, a higher incidence of rib fractures, and an increased average number of rib fractures, of which significantly more were displaced. Conclusions. Displaced rib fractures and moderate-sized pneumothoraces are significant factors associated with chest tube placement in a victim of blunt trauma with occult pneumothorax. The optimal timing for the first follow-up chest X-ray remains unclear.http://dx.doi.org/10.1155/2019/9274697 |
| spellingShingle | Michael Paplawski Swapna Munnangi Jody C. Digiacomo Edwin Gonzalez Ashley Modica Shawndeep S. Tung Catherine Ko Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax Critical Care Research and Practice |
| title | Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax |
| title_full | Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax |
| title_fullStr | Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax |
| title_full_unstemmed | Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax |
| title_short | Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax |
| title_sort | factors associated with chest tube placement in blunt trauma patients with an occult pneumothorax |
| url | http://dx.doi.org/10.1155/2019/9274697 |
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