Presentation Title

Chest tube output, duration and length of stay are similar for “occult” vs. “non-occult” thoracic injury

Faculty Mentor

Mark Langdorf

Start Date

18-11-2017 2:00 PM

End Date

18-11-2017 2:15 PM

Location

9-273

Session

Bio Sciences 3

Type of Presentation

Oral Talk

Subject Area

health_nutrition_clinical_science

Abstract

The “pan scan” strategy for blunt trauma patients has been adopted by many American trauma centers to avoid missing significant injury. CT of the chest (CCT) identifies “occult” injuries not found on initial chest radiograph (CXR), for which 40.8% and 29.1% of patients with hemothorax (HTX) and pneumothorax (PTX) respectively receive chest tube drainage. The value of chest tubes for “occult” injury is questionable. We compared output, duration, and length of stay between chest tubes placed for “occult” vs. “non-occult” (CXR-visible) injury. Methods: We reviewed a prospective cohort of 136 patients with blunt chest trauma who had chest tubes placed from a Level I trauma center in 2010-13. Patients had tubes on one or both sides, for a total of 163 chest tubes. 151 chest tubes (92.6%) were in patients with PTX, 88 chest tubes (64.7%) were in patients with HTX, and 77 chest tubes (47.2%) were in patients with both PTX and HTX. Our primary outcome measure was total chest tube output between “occult” and “non-occult”. Our secondary comparisons were initial and first 24 hour output for any HTX, duration of chest tube placement and hospital length of stay (LOS). Results: Total chest tube output for “occult” patients was 1558+1919cc vs. 1123+1076cc for “non-occult” (p = .126). Initial output, first 24 hour output, duration of chest tube placement, and length of stay were not statistically significant. Conclusions: Chest tube output, duration and length of stay are similar for chest tubes placed in “occult” and “not occult” injury. This finding might influence the decision to not forgo chest tube for “occult” injuries. Prospective study is needed for firm conclusions.

Summary of research results to be presented

Total chest tube output for “occult” patients was 1558+1919cc vs. 1123+1076cc for “non-occult” (p = .126). However, total chest tube output for patients with HTX was 1537+1226cc for “occult” vs 1917+2130cc for “not occult” (p = 0.038). Chest tube duration for patients with PTX was 4.8+3.9 days for “occult” and 6.3+4.9 days for “not occult” (p = 0.58). Initial output, first 24 hour output, duration of chest tube placement, and length of stay were not statistically significant.

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Nov 18th, 2:00 PM Nov 18th, 2:15 PM

Chest tube output, duration and length of stay are similar for “occult” vs. “non-occult” thoracic injury

9-273

The “pan scan” strategy for blunt trauma patients has been adopted by many American trauma centers to avoid missing significant injury. CT of the chest (CCT) identifies “occult” injuries not found on initial chest radiograph (CXR), for which 40.8% and 29.1% of patients with hemothorax (HTX) and pneumothorax (PTX) respectively receive chest tube drainage. The value of chest tubes for “occult” injury is questionable. We compared output, duration, and length of stay between chest tubes placed for “occult” vs. “non-occult” (CXR-visible) injury. Methods: We reviewed a prospective cohort of 136 patients with blunt chest trauma who had chest tubes placed from a Level I trauma center in 2010-13. Patients had tubes on one or both sides, for a total of 163 chest tubes. 151 chest tubes (92.6%) were in patients with PTX, 88 chest tubes (64.7%) were in patients with HTX, and 77 chest tubes (47.2%) were in patients with both PTX and HTX. Our primary outcome measure was total chest tube output between “occult” and “non-occult”. Our secondary comparisons were initial and first 24 hour output for any HTX, duration of chest tube placement and hospital length of stay (LOS). Results: Total chest tube output for “occult” patients was 1558+1919cc vs. 1123+1076cc for “non-occult” (p = .126). Initial output, first 24 hour output, duration of chest tube placement, and length of stay were not statistically significant. Conclusions: Chest tube output, duration and length of stay are similar for chest tubes placed in “occult” and “not occult” injury. This finding might influence the decision to not forgo chest tube for “occult” injuries. Prospective study is needed for firm conclusions.