Tube Thoracostomy Complications Increase Cost.

Area of Science:

• Thoracic Surgery
• Trauma Care
• Health Economics

Background:

• Tube thoracostomy (TT) is a critical intervention for thoracic pathologies.
• Ineffective TT placement is frequent, leading to complications and additional interventions.
• Complicated TT insertion poses a significant financial burden on healthcare systems.

Purpose of the Study:

• To investigate the association between complicated tube thoracostomy (TT) insertion and increased hospitalization costs.
• To quantify the cost differences between complicated and uncomplicated TT procedures.
• To identify specific complication types that contribute most to increased healthcare expenditure.

Main Methods:

• Retrospective review of adult trauma patients undergoing TT at a Level 1 trauma center (2012-2013).
• Exclusion of intraoperative or image-guided TT placements.
• Analysis of TT insertion costs, including equipment, radiographs, and subsequent interventions, using hospital billing records.

Main Results:

• Out of 246 TTs in 154 patients, 90 (37%) had complications.
• Complicated TT insertion was associated with a 9-fold increase in median cost compared to uncomplicated TTs (p=0.001).
• Insertional complications resulted in a 21-fold cost increase due to operative/radiologic interventions (p=0.0001).

Conclusions:

• Tube thoracostomy complications, especially insertional types, lead to substantially higher hospitalization costs.
• The need for operative or radiologic repair significantly drives up expenses for complicated TT insertions.
• Minimizing TT complications is crucial for reducing healthcare costs in trauma patients.