ArticleWorld journal of surgery2017
Tube Thoracostomy Complications Increase Cost.
Article in World journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 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
- Percutaneous pigtail catheter versus chest tube for the treatment of pediatric traumatic hemothorax: An Eastern Association for the Surgery of Trauma multicenter study.The journal of trauma and acute care surgery · 2025Article
- A comprehensive review of catheter dislodgement: prevalence, clinical impact, and innovations in securement devices.npj biomedical innovations · 2025Review
- Closed Tube Thoracostomy Morbidity Rate in a Philippine Tertiary Government Hospital: 6-Year Review.Acta medica Philippina · 2025Article
- 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
- 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
- Narrative review of vascular iatrogenic trauma and endovascular treatment.Annals of translational medicine · 2021Review
- Using cable ties to connect thoracostomy tubes to drainage devices decreases frequency of unplanned disconnection.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- Clinical consequences of chest tube malposition in trauma resuscitation: single-center experience.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019Article
- Presumptive antibiotics in tube thoracostomy for traumatic hemopneumothorax: a prospective, Multicenter American Association for the Surgery of Trauma Study.Trauma surgery & acute care open · 2019Article
- Affordable Laparoscopic Camera System (ALCS) Designed for Low- and Middle-Income Countries: A Feasibility Study.World journal of surgery · 2018Article
- The Benefit of Ultrasound in Deciding Between Tube Thoracostomy and Observative Management in Hemothorax Resulting from Blunt Chest Trauma.World journal of surgery · 2018Article
- External Validation of a Tube Thoracostomy Complication Classification System.World journal of surgery · 2018Article
- Tube Thoracostomy Complications: More to Learn.World journal of surgery · 2018Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTube thoracostomy (TT) can be an effective therapy for thoracic pathologies. Ineffective placement of TT is common and associated with significant complications. Complications require additional interventions to repair damaged tissues or replace dysfunctional TT. We hypothesize that complicated TT insertion increases cost to the hospital system.
methodsAdult trauma patients requiring TT at a level 1 trauma center (2012-2013) were reviewed. Intraoperative or image-guided TT placements were excluded. Baseline demographics and TT insertion cost (normalized and assigned by hospital billing records) were recorded. Costs included initial TT equipment, radiographs, and subsequent operative or radiologic intervention to correct TT complications. Complications were categorized using previously validated method. Secondary outcomes included: number of TT inserted, number of chest radiographs performed, and TT dwell time utilizing a standardized TT discontinuation protocol.
resultsA total of 154 patients with 246 TT were included. Ninety TT (37%) had complication. Complication categories are postremoval (n = 15, 16.7%), insertional (n = 13, 14.4%), positional (n = 62, 68.9%). Overall median complicated TT cost was 9 times greater than uncomplicated TT insertion, p = 0.001. Insertional complications median cost 21 times greater than an uncomplicated, due to operative and radiologic interventions (p = 0.0001). Positional and postremoval complication rates increased median cost by 3 times compared to uncomplicated TT (p = 0.03). Operative or radiologic interventions (n = 10) were performed for organ injury or uncontrolled hemo-/pneumothorax. Increased dwell time median [IQR] was associated with complicated TT compared to uncomplicated 3 [1-5] versus 2 [1-3], p = 0.01.
conclusionTT is a common procedure. TT complications are often considered benign. However, patients with a complicated TT insertion, especially related to insertional subtypes, have markedly increased hospitalization costs due to need for operative or radiologic repair. LEVEL OF EVIDENCE: Level V-retrospective study. STUDY TYPE: This is a retrospective single-institution study.
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Registered trials
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