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External Validation of a Tube Thoracostomy Complication Classification System
Yoginee Sritharen1, Matthew C Hernandez2, Nadeem N Haddad1
1Division of Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
World Journal of Surgery
|September 22, 2017
Summary
This study validates a tube thoracostomy (TT) complication classification system in South African trauma patients. The robust system accurately categorized 16% of TT complications, aiding future strategy development.
Area of Science:
- Trauma Surgery
- Thoracic Procedures
- Medical Device Complications
Background:
- Tube thoracostomy (TT) is a frequent procedure with notable complication rates.
- A validated taxonomy for classifying TT complications is currently lacking.
- This study aimed to validate an existing TT complication taxonomy in a South African trauma cohort.
Purpose of the Study:
- To validate a tube thoracostomy (TT) complication classification system.
- To assess the applicability of a US-developed TT complication taxonomy in a South African trauma population.
- To provide a standardized method for comparing TT complication rates.
Main Methods:
- Post hoc analysis of a prospectively collected trauma database (2010-2013).
- Inclusion of 1010 patients who underwent bedside TT insertion.
- Exclusion of operatively placed or image-guided TT.
- Categorization of complications using a published classification protocol.
Main Results:
- 16% of patients (162/1010) experienced TT complications.
- Penetrating trauma had lower complication rates (11%) than blunt trauma (26%).
- Intern-placed TTs had higher complication rates (17%) than resident-placed TTs (7%).
- Major complication categories included insertional (38%) and positional (44%).
Conclusions:
- The validated TT complication classification system proved robust in a South African trauma cohort.
- Standardized classification enables equitable comparison of TT complication rates.
- This taxonomy can inform strategies to improve TT placement and reduce complications.