Decision-making concordance in thoracic drain management: is necessary previous experience?
Álvaro Fuentes-Martín1, Miriam Suena Doncel2, José Soro García1
1Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Servicio de Cirugía Torácica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Cirugia Espanola
|October 19, 2024
Summary
Digital systems for thoracic drains significantly improve decision-making concordance for drain removal, regardless of healthcare personnel experience. This enhances patient safety and reduces reliance on senior specialists.
Area of Science:
- Thoracic surgery
- Medical device technology
- Clinical decision-making
Background:
- Effective thoracic drainage management is crucial for post-lung resection recovery.
- Variability in drain removal decisions can impact patient outcomes.
- Assessing decision concordance based on drainage system type and operator experience is important.
Purpose of the Study:
- To evaluate the concordance of thoracic drain removal decisions between experienced and inexperienced personnel.
- To compare decision concordance between conventional systems (CS) and digital systems (DS).
- To determine the impact of drainage system type on interobserver variability.
Main Methods:
- Prospective, comparative, and stratified randomization study.
- Interobserver variability assessed between senior specialists and inexperienced personnel.
- Thoracic drains connected to conventional systems (CS) or digital systems (DS) were compared.
- Drain removal decisions recorded over three postoperative days.
Main Results:
- Overall concordance for drain removal was moderate (kappa = 0.452).
- Conventional systems showed low concordance (kappa = 0.188, 61.7% agreement).
- Digital systems demonstrated substantial concordance (kappa = 0.716, 86.4% agreement), irrespective of operator experience.
Conclusions:
- Digital systems significantly enhance concordance in thoracic drain management decisions.
- The use of digital systems improves patient safety and reduces dependency on specialized personnel.
- Digital systems offer reliable decision support across varying levels of healthcare professional experience.
Keywords:
Air leakChest drainageChest tubeConcordancia interobservacionalDispositivos electrónicos de drenajeDrenaje pleuralDrenaje torácicoElectronic drainage systemFuga aéreaInterobserver concordanceLung resectionManejo postoperatorioPatient safetyPostoperative outcomesResección pulmonarSeguridad del pacienteThoracic drainageMore Related Videos
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