ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2016
Occult pneumothorax in blunt trauma: is there a need for tube thoracostomy?
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.
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12 citing papers in PubMed, 33 citations in OpenAlex.
- From diagnosis to therapy: the acute traumatic hemothorax - an orientation for young surgeons.Innovative surgical sciences · 2023Review
- Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision.Journal of clinical medicine · 2022Article
- Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary?Surgery in practice and science · 2022Article
- Percutaneous Chest Tube for Pleural Effusion and Pneumothorax.Seminars in interventional radiology · 2022Review
- Failure of observation and need for delayed tube thoracostomy in 197 unselected patients with occult pneumothorax: a retrospective study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Pneumothorax in patients with respiratory failure in ICU.Journal of thoracic disease · 2021Review
- Chest tube output, duration, and length of stay are similar for pneumothorax and hemothorax seen only on computed tomography vs. chest radiograph.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Occult Pneumothorax in Patients Presenting with Blunt Chest Trauma: An Observational Analysis.Qatar medical journal · 2020Article
- Article
- Hemothorax: A Review of the Literature.Clinical pulmonary medicine · 2020Article
- Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax.Critical care research and practice · 2019Article
- Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital.Singapore medical journal · 2018Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
INTRODUCTION/
backgroundOccult pneumothorax (OPTX) is defined as air within the pleural cavity that is undetectable on normal chest X-rays, but identifiable on computed tomography. Currently, consensus is divided between tube thoracostomy and conservative management for OPTX.
methodsThe aim of this retrospective study is to determine whether OPTX can be managed conservatively and whether any adverse events occur under conservative management. Data on all trauma patients from 1 Jan 2010 to 31 December 2012 were obtained from our hospital's trauma registry. All patients with occult pneumothorax who had chest X-ray (CXR) and any CT scan visualizing the thorax were included. The exclusion criteria included those with penetrating wounds; CXR showing pneumothorax, hemothorax, or hemopneumothorax; those with prophylactic chest tube insertion before CT; and those with no CT diagnosis of OPTX. The complications of these patients were analyzed to determine if tube thoracostomy is necessary for OPTX and whether not inserting it would alter the outcome significantly.
resultsA total of 1564 cases were reviewed and 83 patients were included. Of these 83 patients, 35 (42.2 %) had tube thoracostomy after OPTX detection and 48 (57.8 %) were observed initially. Patients who had tube thoracostomy had similar ISS compared to those without (median ISS 17 vs. 18.5, p = 0.436). Out of the 48 patients who did not have tube thoracostomy on detection of an OPTX, 4 (8.3 %) had complications. In the group of 35 patients who had tube thoracostomy on detection of an OPTX, 7 (20 %) had complications. Of the 83 patients, a total of 12 patients had IPPV, of which 7 (58.3 %) had tube thoracostomy and 5 (41.7 %) did not. Patients who had tube thoracostomy under our care have a statistically significant likelihood of experiencing any complication compared to those without tube thoracostomy (odds ratio 9.92. The median length of stay was also longer (13 days) in those who had tube thoracostomy compared to those without (5 days) (p value = 0.008).
conclusionsOur study suggests that patients with OPTX can be managed conservatively with close monitoring, but only in areas with ready access to emergency facilities should any adverse events occur.
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