Follow-up chest radiographs after traumatic pneumothorax or hemothorax in the outpatient setting: a retrospective review.
OBJECTIVE
To evaluate the need for obtaining postdischarge chest radiographs for trauma patients who were treated with a thoracostomy tube.


METHODS
A retrospective medical record review was conducted for all patients treated with a thoracostomy tube while admitted to the trauma service at Saint Louis University Hospital over a 12-month period. Patients who died during their hospital stay were excluded.


RESULTS
During the 12-month study period, 155 trauma patients who were treated with a thoracostomy tube were discharged from the hospital. The indications for the thoracostomy tube were pneumothorax (n = 79, 51% of study population), hemopneumothorax (n = 34, 22%), hemothorax (n = 28, 18%), diaphragmatic rupture/laceration (n = 8, 5%), post thoracotomy (n = 4, 3%), and iatrogenic pneumothorax (n = 2, 1%). A follow-up clinic visit was scheduled for 1 to 2 weeks after discharge. Forty patients (26%) were lost to follow-up. Two patients called to report they had no symptoms and canceled their appointments. A total of 113 patients returned for follow-up appointments. Fifty-two patients had a predischarge chest radiograph that was negative for pneumothorax or hemothorax, had no symptoms, had normal results of a physical examination at the time of their clinic visit, and did not have a postdischarge chest radiograph. A total of 61 (54%) had postdischarge chest radiographs. Of that number, 56 (92%) were negative for pneumothorax. Three patients (5%) had a small pneumothorax, and 2 patients (3%) were noted to have a resolving hemothorax. All 5 patients were without symptoms and were released from the trauma service.


CONCLUSIONS
A postdischarge chest radiograph is not indicated for an asymptomatic trauma patient who was treated with a tube thoracostomy and had a predischarge chest radiograph that was negative for pneumothorax or hemothorax.
Golden
P
P
Saint Louis University Hospital, Department of Surgery, MO 63110-0250, USA.
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003663:Decision Trees; D004638:Emergency Treatment; D005260:Female; D006491:Hemothorax / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D013907:Thoracostomy