Beyond the tube: Can we reduce chest tube complications in trauma patients?
Carson Platnick1, Cordelie E Witt2, Fredric M Pieracci1
1Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO 80204, USA.
Background:
We sought to identify opportunities for interventions to mitigate complications of tube thoracostomy (TT).
Methods:
Retrospective review of all trauma patients undergoing TT from 6/30/2016-6/30/2019. Multivariable logistic regression identified independent predictors of complications.
Results:
Out of 451 patients, 171 (37.9%) had at least one TT malpositioning or complication. Placement in the emergency department, placement by emergency medicine physicians, and body mass index >30 kg/m2 were independent predictors of complication. Malpositioning increased the likelihood of early complication (6.5%-53.5%), and early complication increased the likelihood of late complication (4.3%-13.6%). Patients with a late complication had, on average, a 7.56 day longer hospital stay than patients without a late complication.
Conclusion:
TT complications were associated with placement in the emergency department, placement by emergency medicine physicians, and BMI>30 kg/m2. We identified associations between malpositioning, early complications, and late complications, and demonstrated that TT complications impact patient outcomes.
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