Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax
| Autor: | Ashley Modica, Jody C. DiGiacomo, Edwin Gonzalez, Michael Paplawski, Catherine Ko, Shawndeep Tung, Swapna Munnangi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Article Subject business.industry Incidence (epidemiology) Plain film Trauma center lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine Trauma registry lcsh:RC86-88.9 030230 surgery Critical Care and Intensive Care Medicine medicine.disease Occult 03 medical and health sciences Chest tube placement 0302 clinical medicine Pneumothorax Blunt trauma medicine Radiology business Research Article |
| Zdroj: | Critical Care Research and Practice Critical Care Research and Practice, Vol 2019 (2019) |
| ISSN: | 2090-1305 |
| DOI: | 10.1155/2019/9274697 |
| Popis: | Background. An occult pneumothorax is identified by computed tomography but not visualized by a plain film chest X-ray. The optimal management remains unclear.Methods. A retrospective review of an urban level I trauma center’s trauma registry was conducted to identify patients with occult pneumothorax over a 2-year period. Factors predictive of chest tube placement were identified using univariate and multivariate logistic regression analysis.Results. A total of 131 patients were identified, of whom 100 were managed expectantly with an initial period of observation. Ultimately, 42 (32.0%) patients received chest tubes and 89 did not. The patients who received chest tubes had larger pneumothoraces at initial assessment, a higher incidence of rib fractures, and an increased average number of rib fractures, of which significantly more were displaced.Conclusions. Displaced rib fractures and moderate-sized pneumothoraces are significant factors associated with chest tube placement in a victim of blunt trauma with occult pneumothorax. The optimal timing for the first follow-up chest X-ray remains unclear. |
| Databáze: | OpenAIRE |
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