A Prospective Study of 7-Year Experience Using Percutaneous 14-French Pigtail Catheters for Traumatic Hemothorax/Hemopneumothorax at a Level-1 Trauma Center: Size Still Does Not Matter

Zachary M. Bauman, Narong Kulvatunyou, Bellal Joseph, Arpana Jain, Randall S. Friese, Lynn Gries, Terence O’Keeffe, Andy L. Tang, Gary Vercruysse, Peter Rhee

Research output: Research - peer-reviewArticle

Abstract

Background: The effectiveness of 14-French (14F) pigtail catheters (PCs) compared to 32-40F chest tubes (CTs) in patients with traumatic hemothorax (HTX) and hemopneumothorax (HPTX) is becoming more well known but still lacking. The aim of our study was to analyze our cumulative experience and outcomes with PCs in patients with traumatic HTX/HPTX. We hypothesized that PCs would be as effective as CTs. Methods: Using our PC database, we analyzed all trauma patients who required chest drainage for HTX/HPTX from 2008 to 2014. Primary outcomes of interest, comparing PCs to CTs, included initial drainage output in milliliters (mL), tube insertion-related complications, and failure rate. For our statistical analysis, we used the unpaired Student’s t test, Chi-square test, and Wilcoxon rank-sum test. We defined statistical significance as P < 0.05. Results: During the 7-year period, 496 trauma patients required chest drainage for traumatic HTX/HPTX: 307 by CTs and 189 by PCs. PC patients were older (52 ± 21 vs. 42 ± 19, P < 0.001), demonstrated a significantly higher occurrence of blunt trauma (86 vs. 55%, P ≤ 0.001), and had tubes placed in a non-emergent fashion (Day 1 [interquartile range (IQR) 1–3 days] for PC placement vs. Day 0 [IQR 0–1 days] for CT placement, P < 0.001). All primary outcomes of interest were similar, except that the initial drainage output for PCs was higher (425 mL [IQR 200–800 mL] vs. 300 mL [IQR 150–500], P < 0.001). Findings for subgroup analysis among emergent and non-emergent PC placement were also similar to CT placement. Conclusion: PCs had similar outcomes to CTs in terms of failure rate and tube insertion-related complications, and the initial drainage output from PCs was not inferior to that of CTs. The usage of PCs was, however, selective. A future multi-center study is needed to provide additional support and information for PC usage in traumatic HTX/HPTX.

LanguageEnglish (US)
Pages1-7
Number of pages7
JournalWorld Journal of Surgery
DOIs
StateAccepted/In press - Aug 9 2017

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Hemopneumothorax
Hemothorax
Trauma Centers
Catheters
Prospective Studies
Chest Tubes
Drainage
Wounds and Injuries
Nonparametric Statistics
Thorax
Chi-Square Distribution
Databases
Students

ASJC Scopus subject areas

  • Surgery

Cite this

@article{a9ae66d99799463fbf20c548a84510f8,
title = "A Prospective Study of 7-Year Experience Using Percutaneous 14-French Pigtail Catheters for Traumatic Hemothorax/Hemopneumothorax at a Level-1 Trauma Center: Size Still Does Not Matter",
abstract = "Background: The effectiveness of 14-French (14F) pigtail catheters (PCs) compared to 32-40F chest tubes (CTs) in patients with traumatic hemothorax (HTX) and hemopneumothorax (HPTX) is becoming more well known but still lacking. The aim of our study was to analyze our cumulative experience and outcomes with PCs in patients with traumatic HTX/HPTX. We hypothesized that PCs would be as effective as CTs. Methods: Using our PC database, we analyzed all trauma patients who required chest drainage for HTX/HPTX from 2008 to 2014. Primary outcomes of interest, comparing PCs to CTs, included initial drainage output in milliliters (mL), tube insertion-related complications, and failure rate. For our statistical analysis, we used the unpaired Student’s t test, Chi-square test, and Wilcoxon rank-sum test. We defined statistical significance as P < 0.05. Results: During the 7-year period, 496 trauma patients required chest drainage for traumatic HTX/HPTX: 307 by CTs and 189 by PCs. PC patients were older (52 ± 21 vs. 42 ± 19, P < 0.001), demonstrated a significantly higher occurrence of blunt trauma (86 vs. 55%, P ≤ 0.001), and had tubes placed in a non-emergent fashion (Day 1 [interquartile range (IQR) 1–3 days] for PC placement vs. Day 0 [IQR 0–1 days] for CT placement, P < 0.001). All primary outcomes of interest were similar, except that the initial drainage output for PCs was higher (425 mL [IQR 200–800 mL] vs. 300 mL [IQR 150–500], P < 0.001). Findings for subgroup analysis among emergent and non-emergent PC placement were also similar to CT placement. Conclusion: PCs had similar outcomes to CTs in terms of failure rate and tube insertion-related complications, and the initial drainage output from PCs was not inferior to that of CTs. The usage of PCs was, however, selective. A future multi-center study is needed to provide additional support and information for PC usage in traumatic HTX/HPTX.",
author = "Bauman, {Zachary M.} and Narong Kulvatunyou and Bellal Joseph and Arpana Jain and Friese, {Randall S.} and Lynn Gries and Terence O’Keeffe and Tang, {Andy L.} and Gary Vercruysse and Peter Rhee",
year = "2017",
month = "8",
doi = "10.1007/s00268-017-4168-3",
pages = "1--7",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",

}

TY - JOUR

T1 - A Prospective Study of 7-Year Experience Using Percutaneous 14-French Pigtail Catheters for Traumatic Hemothorax/Hemopneumothorax at a Level-1 Trauma Center

T2 - World Journal of Surgery

AU - Bauman,Zachary M.

AU - Kulvatunyou,Narong

AU - Joseph,Bellal

AU - Jain,Arpana

AU - Friese,Randall S.

AU - Gries,Lynn

AU - O’Keeffe,Terence

AU - Tang,Andy L.

AU - Vercruysse,Gary

AU - Rhee,Peter

PY - 2017/8/9

Y1 - 2017/8/9

N2 - Background: The effectiveness of 14-French (14F) pigtail catheters (PCs) compared to 32-40F chest tubes (CTs) in patients with traumatic hemothorax (HTX) and hemopneumothorax (HPTX) is becoming more well known but still lacking. The aim of our study was to analyze our cumulative experience and outcomes with PCs in patients with traumatic HTX/HPTX. We hypothesized that PCs would be as effective as CTs. Methods: Using our PC database, we analyzed all trauma patients who required chest drainage for HTX/HPTX from 2008 to 2014. Primary outcomes of interest, comparing PCs to CTs, included initial drainage output in milliliters (mL), tube insertion-related complications, and failure rate. For our statistical analysis, we used the unpaired Student’s t test, Chi-square test, and Wilcoxon rank-sum test. We defined statistical significance as P < 0.05. Results: During the 7-year period, 496 trauma patients required chest drainage for traumatic HTX/HPTX: 307 by CTs and 189 by PCs. PC patients were older (52 ± 21 vs. 42 ± 19, P < 0.001), demonstrated a significantly higher occurrence of blunt trauma (86 vs. 55%, P ≤ 0.001), and had tubes placed in a non-emergent fashion (Day 1 [interquartile range (IQR) 1–3 days] for PC placement vs. Day 0 [IQR 0–1 days] for CT placement, P < 0.001). All primary outcomes of interest were similar, except that the initial drainage output for PCs was higher (425 mL [IQR 200–800 mL] vs. 300 mL [IQR 150–500], P < 0.001). Findings for subgroup analysis among emergent and non-emergent PC placement were also similar to CT placement. Conclusion: PCs had similar outcomes to CTs in terms of failure rate and tube insertion-related complications, and the initial drainage output from PCs was not inferior to that of CTs. The usage of PCs was, however, selective. A future multi-center study is needed to provide additional support and information for PC usage in traumatic HTX/HPTX.

AB - Background: The effectiveness of 14-French (14F) pigtail catheters (PCs) compared to 32-40F chest tubes (CTs) in patients with traumatic hemothorax (HTX) and hemopneumothorax (HPTX) is becoming more well known but still lacking. The aim of our study was to analyze our cumulative experience and outcomes with PCs in patients with traumatic HTX/HPTX. We hypothesized that PCs would be as effective as CTs. Methods: Using our PC database, we analyzed all trauma patients who required chest drainage for HTX/HPTX from 2008 to 2014. Primary outcomes of interest, comparing PCs to CTs, included initial drainage output in milliliters (mL), tube insertion-related complications, and failure rate. For our statistical analysis, we used the unpaired Student’s t test, Chi-square test, and Wilcoxon rank-sum test. We defined statistical significance as P < 0.05. Results: During the 7-year period, 496 trauma patients required chest drainage for traumatic HTX/HPTX: 307 by CTs and 189 by PCs. PC patients were older (52 ± 21 vs. 42 ± 19, P < 0.001), demonstrated a significantly higher occurrence of blunt trauma (86 vs. 55%, P ≤ 0.001), and had tubes placed in a non-emergent fashion (Day 1 [interquartile range (IQR) 1–3 days] for PC placement vs. Day 0 [IQR 0–1 days] for CT placement, P < 0.001). All primary outcomes of interest were similar, except that the initial drainage output for PCs was higher (425 mL [IQR 200–800 mL] vs. 300 mL [IQR 150–500], P < 0.001). Findings for subgroup analysis among emergent and non-emergent PC placement were also similar to CT placement. Conclusion: PCs had similar outcomes to CTs in terms of failure rate and tube insertion-related complications, and the initial drainage output from PCs was not inferior to that of CTs. The usage of PCs was, however, selective. A future multi-center study is needed to provide additional support and information for PC usage in traumatic HTX/HPTX.

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