Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis
<h3 dir="ltr">Background</h3><p dir="ltr">The frequent use of computed tomography (CT) scan in the evaluation of trauma patients has led to an increase in the diagnosis of hemothorax. This study aimed to assess whether a <u>hemothorax </u>volume of &...
محفوظ في:
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| مؤلفون آخرون: | , , , , , , , , , , |
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2025
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| _version_ | 1864513531544600576 |
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| author | Ismail Mahmood (14150352) |
| author2 | Ali Alomar (22921238) Syed Nabir (14631245) Mohammad Asim (178880) Zahoor Ahmed (12117252) Mohamed Nadeem Ahmed (22921241) Ayman El-Menyar (440103) Monira Mollazehi (9100073) Ruben Peralta (768896) Khalid Ahmed (710040) Sandro Rizoli (67238) Hassan Al-Thani (440106) |
| author2_role | author author author author author author author author author author author |
| author_facet | Ismail Mahmood (14150352) Ali Alomar (22921238) Syed Nabir (14631245) Mohammad Asim (178880) Zahoor Ahmed (12117252) Mohamed Nadeem Ahmed (22921241) Ayman El-Menyar (440103) Monira Mollazehi (9100073) Ruben Peralta (768896) Khalid Ahmed (710040) Sandro Rizoli (67238) Hassan Al-Thani (440106) |
| author_role | author |
| dc.creator.none.fl_str_mv | Ismail Mahmood (14150352) Ali Alomar (22921238) Syed Nabir (14631245) Mohammad Asim (178880) Zahoor Ahmed (12117252) Mohamed Nadeem Ahmed (22921241) Ayman El-Menyar (440103) Monira Mollazehi (9100073) Ruben Peralta (768896) Khalid Ahmed (710040) Sandro Rizoli (67238) Hassan Al-Thani (440106) |
| dc.date.none.fl_str_mv | 2025-08-28T12:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.injury.2025.112532 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Computed_tomography-detected_hemothorax_after_blunt_chest_trauma_Does_everyone_need_an_intervention_A_retrospective_analysis/30962750 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Trauma Hemothorax volume CT scan quantification Failed observation Conservative management |
| dc.title.none.fl_str_mv | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3 dir="ltr">Background</h3><p dir="ltr">The frequent use of computed tomography (CT) scan in the evaluation of trauma patients has led to an increase in the diagnosis of hemothorax. This study aimed to assess whether a <u>hemothorax </u>volume of <300 ml, as determined by CT imaging, can be managed without tube <u>thoracostomy </u>and to identify the factors that recommend its use. </p><h3 dir="ltr">Methods</h3><p dir="ltr">A retrospective observational study was conducted at XXX Trauma Center, including all patients with traumatic hemothorax from June 2014 to January 2020. Patient demographics, injury mechanism, severity, associated <u>chest injuries</u>, indications for tube thoracostomy, <u>mechanical ventilation</u>, hospital length of stay, complications, and outcomes were reviewed. The study compared patients with hemothorax volumes < 300 ml and ≥300 ml and assessed the outcomes of conservative management without tube thoracostomy (conservative management) vs therapeutic management with tube thoracostomy placement (failed observation). </p><h3 dir="ltr">Results</h3><p dir="ltr">A total of 254 patients with hemothorax were included. Most patients (79 %) were successfully managed without tube thoracostomy insertion, while 53 patients (21 %) required tube thoracostomy after failure of conservative management. Patients with larger hemothorax volumes were significantly more likely to require tube thoracostomy (<i>p</i> = 0.001) and had significantly longer hospital stays (<i>p</i> = 0.021). Those with failed observation had higher<u> injury severity scores</u> (<i>p</i> = 0.001), more associated <u>lung contusions</u> (<i>p</i> = 0.015), <u>pneumothorax</u> (<i>p</i> = 0.024), and <u>rib fractures</u> (<i>p</i> = 0.001). They also had larger hemothorax volumes (<i>p</i> = 0.001), a greater need for mechanical ventilation (<i>p</i> = 0.001), and prolonged hospitalization (<i>p</i>= 0.001). Predictors of failed observation included high hemothorax volume (≥300 ml), ISS, and greater number of fractured ribs. </p><h3 dir="ltr">Conclusion</h3><p dir="ltr">Conservative management (without tube thoracostomy) was adequate for most patients with <300 ml of hemothorax volumes. Quantitative assessment of hemothorax volume should be considered part of the clinical decision-making algorithm. Further research is needed to refine management strategies and improve outcomes for traumatic hemothorax.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Injury<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.injury.2025.112532" target="_blank">https://dx.doi.org/10.1016/j.injury.2025.112532</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_643892271a49b2b050438e4f5958c951 |
| identifier_str_mv | 10.1016/j.injury.2025.112532 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30962750 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysisIsmail Mahmood (14150352)Ali Alomar (22921238)Syed Nabir (14631245)Mohammad Asim (178880)Zahoor Ahmed (12117252)Mohamed Nadeem Ahmed (22921241)Ayman El-Menyar (440103)Monira Mollazehi (9100073)Ruben Peralta (768896)Khalid Ahmed (710040)Sandro Rizoli (67238)Hassan Al-Thani (440106)Biomedical and clinical sciencesClinical sciencesTraumaHemothorax volumeCT scan quantificationFailed observationConservative management<h3 dir="ltr">Background</h3><p dir="ltr">The frequent use of computed tomography (CT) scan in the evaluation of trauma patients has led to an increase in the diagnosis of hemothorax. This study aimed to assess whether a <u>hemothorax </u>volume of <300 ml, as determined by CT imaging, can be managed without tube <u>thoracostomy </u>and to identify the factors that recommend its use. </p><h3 dir="ltr">Methods</h3><p dir="ltr">A retrospective observational study was conducted at XXX Trauma Center, including all patients with traumatic hemothorax from June 2014 to January 2020. Patient demographics, injury mechanism, severity, associated <u>chest injuries</u>, indications for tube thoracostomy, <u>mechanical ventilation</u>, hospital length of stay, complications, and outcomes were reviewed. The study compared patients with hemothorax volumes < 300 ml and ≥300 ml and assessed the outcomes of conservative management without tube thoracostomy (conservative management) vs therapeutic management with tube thoracostomy placement (failed observation). </p><h3 dir="ltr">Results</h3><p dir="ltr">A total of 254 patients with hemothorax were included. Most patients (79 %) were successfully managed without tube thoracostomy insertion, while 53 patients (21 %) required tube thoracostomy after failure of conservative management. Patients with larger hemothorax volumes were significantly more likely to require tube thoracostomy (<i>p</i> = 0.001) and had significantly longer hospital stays (<i>p</i> = 0.021). Those with failed observation had higher<u> injury severity scores</u> (<i>p</i> = 0.001), more associated <u>lung contusions</u> (<i>p</i> = 0.015), <u>pneumothorax</u> (<i>p</i> = 0.024), and <u>rib fractures</u> (<i>p</i> = 0.001). They also had larger hemothorax volumes (<i>p</i> = 0.001), a greater need for mechanical ventilation (<i>p</i> = 0.001), and prolonged hospitalization (<i>p</i>= 0.001). Predictors of failed observation included high hemothorax volume (≥300 ml), ISS, and greater number of fractured ribs. </p><h3 dir="ltr">Conclusion</h3><p dir="ltr">Conservative management (without tube thoracostomy) was adequate for most patients with <300 ml of hemothorax volumes. Quantitative assessment of hemothorax volume should be considered part of the clinical decision-making algorithm. Further research is needed to refine management strategies and improve outcomes for traumatic hemothorax.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Injury<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.injury.2025.112532" target="_blank">https://dx.doi.org/10.1016/j.injury.2025.112532</a></p>2025-08-28T12:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.injury.2025.112532https://figshare.com/articles/journal_contribution/Computed_tomography-detected_hemothorax_after_blunt_chest_trauma_Does_everyone_need_an_intervention_A_retrospective_analysis/30962750CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/309627502025-08-28T12:00:00Z |
| spellingShingle | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis Ismail Mahmood (14150352) Biomedical and clinical sciences Clinical sciences Trauma Hemothorax volume CT scan quantification Failed observation Conservative management |
| status_str | publishedVersion |
| title | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| title_full | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| title_fullStr | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| title_full_unstemmed | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| title_short | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| title_sort | Computed tomography-detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis |
| topic | Biomedical and clinical sciences Clinical sciences Trauma Hemothorax volume CT scan quantification Failed observation Conservative management |