title: Efficiency Analysis of Direct Video-Assisted Thoracoscopic Surgery in Elderly Patients with Blunt Traumatic Hemothorax without an Initial Thoracostomy.
abstract: Hemothorax is common in elderly patients following blunt chest trauma. Traditionally, tube thoracostomy is the first choice for managing this complication. The goal of this study was to determine the benefits of this approach in elderly patients with and without an initial tube thoracostomy. Seventy-eight patients aged >65 years with blunt chest trauma and stable vital signs were included. All of them had more than 300 mL of hemothorax, indicating that a tube thoracostomy was necessary. The basic demographic data and clinical outcomes of patients with hemothorax who underwent direct video-assisted thoracoscopic surgery without a tube thoracostomy were compared with those who received an initial tube thoracostomy. Patients who did not receive a thoracostomy had lower posttrauma infection rates (28.6% versus 56.3%, P = 0.061) and a significantly shorter length of stay in the intensive care unit (3.13 versus 8.27, P = 0.029) and in the hospital (15.93 versus 23.17, P = 0.01) compared with those who received a thoracostomy. The clinical outcomes in the patients who received direct VATS were more favorable compared with those of the patients who did not receive direct VATS.
authors.affiliation: Division of Trauma, Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung 807, Taiwan; Institute of Business and Management, National Chiao Tung University, Hsinchu 300, Taiwan.
authors.forename: Wen-Yen
authors.initials: WY
authors.lastname: Huang
authors.affiliation: Division of Trauma, Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung 807, Taiwan.
authors.forename: I-Yin
authors.initials: IY
authors.lastname: Lu
authors.affiliation: Institute of Business and Management, National Chiao Tung University, Hsinchu 300, Taiwan.
authors.forename: Chyan
authors.initials: C
authors.lastname: Yang
authors.affiliation: Division of Trauma, Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung 807, Taiwan; Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan 330, Taiwan.
authors.forename: Yi-Pin
authors.initials: YP
authors.lastname: Chou
authors.affiliation: Emergency Department, Fooyin University Hospital, Pingtung County 928, Taiwan; Department of Medical Technology, Fooyin University, Kaohsiung 928, Taiwan; Department of Nursing, Tajen University, Yanpu Township, Pingtung County 928, Taiwan; Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Department of Emergency Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
authors.forename: Hsing-Lin
authors.initials: HL
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006491:Hemothorax / Q000601:surgery*; D006801:Humans; D008297:Male; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000601:surgery*