Abstract
Background
Obtaining a chest radiograph (CXR) after chest tube (CT) removal to rule out a pneumothorax
is a universal practice. However, the yield of this CXR has not been well documented.
Additionally, most iatrogenic pneumothoraces resulting from CT removal are atmospheric
in origin, asymptomatic, and can be observed. Recently, we have begun to discontinue
routine CXR for CT removal. We evaluated our experience with CT removal to clarify
the usefulness of routine post CT removal CXR.
Methods
After IRB approval, a retrospective study was conducted on patients who had a CT placed
in the past decade. Cardiac patients requiring a CT were excluded. Patient demographics,
diagnosis, treatments, and outcomes were collected. Patients were divided into two
groups, those with a CXR after CT removal (Group 1) and those without (Group 2). Percentages
were compared with Chi square with Yates correction.
Results
462 patients were identified (group 1 = 327, group 2 = 135). Indications for CT included; empyema (n = 176), lung resection (n = 146), pneumothorax (n = 71), pleural effusion (n = 26), spinal fusion (n = 20), trauma (n = 16), and miscellaneous (n = 7). Seven patients (2.1%) in group 1 required reinsertion for pneumothorax (n = 4), empyema (n = 2), and pleural effusion (n = 1) compared to 1 patient (0.7%) in group 2 who required reinsertion for pleural effusion.
This difference was not significant (P = 0.2).
Conclusions
In non-cardiac patients with a CT, tube reinsertion is uncommon and tube replacement
is secondary to symptoms. Therefore, routine post CT removal CXR is not necessary.
CXR in these patients should be obtained based upon clinical indications after CT
removal.
Key words
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Article info
Publication history
Published online: January 30, 2014
Accepted:
January 11,
2014
Received in revised form:
January 7,
2014
Received:
December 3,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
