ArticleThe journal of trauma and acute care surgery2016
Tube thoracostomy: Increased angle of insertion is associated with complications.
Article in The journal of trauma and acute care surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Complications in tube thoracostomy: Systematic review and meta-analysis.The journal of trauma and acute care surgery · 2018Pooled it
- Managing tube thoracostomy with thoracic ultrasound: results from a randomized pilot study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Trial
- Comparison of a novel, endoscopic chest tube insertion technique versus the standard, open technique performed by novice users in a human cadaver model: a randomized, crossover, assessor-blinded study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Trial
- A novel simulation model for tube thoracostomy.SAGE open medicine · 2023Article
- An observational simulation-based study of the accuracy of intercostal drain placement and factors influencing placement.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Hemothorax: A Review of the Literature.Clinical pulmonary medicine · 2020Article
- Chest drain and thoracotomy for chest trauma.Journal of thoracic disease · 2019Review
- Application of the AAST EGS Grade for Adhesive Small Bowel Obstruction to a Multi-national Patient Population.World journal of surgery · 2018Article
- External Validation of a Tube Thoracostomy Complication Classification System.World journal of surgery · 2018Article
- Tube Thoracostomy Complications Increase Cost.World journal of surgery · 2017Article
- Visually guided tube thoracostomy insertion comparison to standard of care in a large animal model.Injury · 2017Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
introductionTube thoracostomy (TT), considered a routine procedure, has significant complications. Current recommendations for placement rely on surface anatomy. There is no information to guide operators regarding angle of insertion relative to chest wall. We aim to determine if angle of insertion is associated with complications of TT.
methodsWe performed a retrospective review of adult trauma patients who necessitated TT at a Level I trauma center over a 2-year period (January 2012 to December 2013). Tube thoracostomies performed intraoperatively or using radiological guidance were excluded. Thoracic anteroposterior or posteroanterior radiographs were reviewed to determine the angle of insertion of TT relative to the thoracic wall. A previously validated classification method was used to categorize complications. Descriptive and univariate statistics were used to compare angle of insertion and complicated versus uncomplicated TT.
resultsReview identified 154 patients who underwent a total of 246 TT placed for emergent trauma. All patients had a postprocedural chest x-ray. We identified 90 complications (37%) over the study period. One hundred forty-four of the TTs reviewed had an angle of insertion less than 45 degrees of which there were 27 complications (19%). One hundred two of the TTs had an angle greater than 45 degrees and 63 complications (62%); p < 0.0001.
conclusionsTube thoracostomy insertion is inherently dangerous. Placement of TT using a higher angle of insertion greater than 45 degrees is associated with increased complications. Further prospective studies quantifying TT angle of insertion on outcomes are needed. LEVEL OF EVIDENCE: Therapeutic study, level IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.