Beyond the tube: Can we reduce chest tube complications in trauma patients?

Background We sought to identify opportunities for interventions to mitigate complications of tube thoracostomy (TT). Methods Retrospective review of all trauma patients undergoing TT from 6/30/2016–6/30/2019. Multivariable logistic regression identified independent predictors of complications. Results Out of 451 patients, 171 (37.9%) had at least one TT malpositioning or complication. Placement in the emergency department, placement by emergency medicine physicians, and body mass index >30 kg/m2 were independent predictors of complication. Malpositioning increased the likelihood of early complication (6.5%–53.5%), and early complication increased the likelihood of late complication (4.3%–13.6%). Patients with a late complication had, on average, a 7.56 day longer hospital stay than patients without a late complication. Conclusion TT complications were associated with placement in the emergency department, placement by emergency medicine physicians, and BMI>30 kg/m2. We identified associations between malpositioning, early complications, and late complications, and demonstrated that TT complications impact patient outcomes.