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学术急诊医学档案

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卷 5 编号 1 (2017)

十月 2017

Comparing the Quality and Complications of Tube Thoracostomy by Emergency Medicine and Surgery Residents; a Cohort Study

  • Parvin Kashani
  • Sepideh Harati
  • Ali Shirafkan
  • Alireza Amirbeigi
  • Hamid Reza Hatamabadi

学术急诊医学档案, 卷 5 编号 1 (2017), 1 十月 2017 , 第 e33 页
https://doi.org/10.22037/aaem.v5i1.157 已出版: 2017-01-30

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摘要

Introduction: Tube thoracostomy complications depend on the operator’s skill, patients’ general condition and the place in which the procedure is done. The present study aimed to compare the quality and complications of tube thoracostomy carried out by emergency medicine residents (EMRs) and surgery residents (SRs).

Methods: This cohort study was conducted on 18-60 years old trauma patients in need of tube thoracostomy presenting to two academic emergency departments. Quality of tube placement and its subsequent complications until tube removal were compared between SRs and EMRs using SPSS 20.

Results: 72 patients with the mean age of 37.1±14.1 years were studied (86.1% male). 23 (63.8%) cases were complicated in SRs and 22 (61.1%) cases in EMRs group (total= 62.5%). Chest drain dislodgement (22.2% in SRs vs. 22.2% EMRs; p>0.99), drainage failure (19.4% in SRs vs. 16.7% EMRs; p=0.50), and surgical site infection (11.1% in SRs vs. 19.4% EMRs; p=0.25) were among the most common observed complications. The overall odds ratio of complication development was 0.89 (95% CI: 0.35-2.25, p = 0.814) for SRs and 1.12 (95% CI: 0.28-4.53, p = 0.867) for EMRs.

Conclusion: The findings of the present study showed no significant difference between SRs and EMRs regarding quality of tube thoracostomy placement and its subsequent complications for trauma patients. The rate of complications were interestingly high (>60%) for both groups.

关键词:
  • Thoracostomy
  • emergency medicine
  • general surgery
  • postoperative complications
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Kashani P, Harati S, Shirafkan A, Amirbeigi A, Hatamabadi HR. Comparing the Quality and Complications of Tube Thoracostomy by Emergency Medicine and Surgery Residents; a Cohort Study. Arch Acad Emerg Med [网际网络]. 2017年1月30日 [见引于 2026年7月7日];5(1):e33. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/157
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参考

Forouzanfar MM, Safari S, Niazazari M, Baratloo A, Hashemi B, Hatamabadi HR, et al. Clinical decision rule to prevent unnecessary chest Xâ€ray in patients with blunt multiple traumas. Emergency Medicine Australasia. 2014;26(6):561-6.

Safari S, Baratloo A, Negida AS, Taheri MS, Hashemi B, Selkisari SH. Comparing the Interpretation of Traumatic Chest X-Ray by Emergency Medicine Specialists and Radiologists. 2014.

Paydar S, Moghaninasab A, Asiaei E, Sabetian Fard Jahromi G, Bolandparvaz S, Abbasi H. Outcome of Patients Underwent Emergency Department Thoracotomy and Its Predictive Factors. Emergency. 2014;2(3):125-9.

Menger R, Telford G, Kim P, Bergey MR, Foreman J, Sarani B, et al. Complications following thoracic trauma managed with tube thoracostomy. Injury. 2012;43(1):46-50.

Bailey R. Complications of tube thoracostomy in trauma. Journal of accident & emergency medicine. 2000;17(2):111-4.

Collop NA, Kim S, Sahn SA. Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital. CHEST Journal. 1997;112(3):709-13.

Cho DY, Sohn DS, Cheon YJ, Hong K. Complications of a Tube Thoracostomy Performed by Emergency Medicine Residents. Journal of the Korean Society of Traumatology. 2012;25(2):37-43.

Mancini MC. Blunt Chest Trauma. inglés) Thoracic Surgery eMedicine com Consultado el. 2012;30.

Sirleaf M, Jefferson B, Christmas AB, Sing RF, Thomason MH, Huynh TT. Comparison of procedural complications between resident physicians and advanced clinical providers. Journal of Trauma and Acute Care Surgery. 2014;77(1):143-7.

Dural K, Gulbahar G, Kocer B, Sakinci U. Research article A novel and safe technique in closed tube thoracostomy. 2010.

Safari S, Baratloo A, Negida AS, Taheri MS, Hashemi B, Selkisari SH. Comparing the Interpretation of Traumatic Chest X-Ray by Emergency Medicine Specialists and Radiologists. Archives of trauma research. 2014;3(4).

Ball CG, Lord J, Laupland KB, Gmora S, Mulloy RH, Ng AK, et al. Chest tube complications: How well are we training our residents? Canadian Journal of Surgery. 2007;50(6):450-8.

Sethuraman KN, Duong D, Mehta S, Director T, Crawford D, St George J, et al. Complications of tube thoracostomy placement in the emergency department. The Journal of emergency medicine. 2011;40(1):14-20.

AZIZ A, PIRZADA MT, HAIDER J, ALAM SN, MALIK KA. COMPLICATIONS OF TUBE THORACOSTOMY IN ISOLATED CHEST INJURIES. Journal of Surgery Pakistan (International). 2010;15(3):126.

Chan L, Reilly KM, Henderson C, Kahn F, Salluzzo RF. Complication rates of tube thoracostomy. The American journal of emergency medicine. 1997;15(4):368-70.

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