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. 2022 Sep 23;12(10):1570.
doi: 10.3390/jpm12101570.

Risk Factors for Retained Hemothorax after Trauma: A 10-Years Monocentric Experience from First Level Trauma Center in Italy

Marta Rossmann  1 , Michele Altomare  1   2 , Isabella Pezzoli  1 , Arianna Abruzzese  1 , Andrea Spota  1 , Marco Vettorello  1 , Stefano Piero Bernardo Cioffi  1 , Francesco Virdis  1 , Roberto Bini  1 , Osvaldo Chiara  1   3 , Stefania Cimbanassi  1   3
Affiliations

Risk Factors for Retained Hemothorax after Trauma: A 10-Years Monocentric Experience from First Level Trauma Center in Italy

Marta Rossmann et al. J Pers Med. .

Abstract

Thoracic trauma occurs in 20-25% of all trauma patients worldwide and represents the third cause of trauma-related mortality. Retained hemothorax (RH) is defined as a residual hematic pleural effusion larger than 500 mL after 72 h of treatment with a thoracic tube. The aim of this study is to investigate risk factors for the development of RH in thoracic trauma and predictors of surgery. A retrospective, observational, monocentric study was conducted in a Trauma Hub Hospital in Milan, recording thoracic trauma from January 2011 to December 2020. Pre-hospital peripheric oxygen saturation (SpO2) was significantly lower in the RH group (94% vs. 97%, p = 0.018). Multivariable logistic regression analysis identified, as independent predictors of RH, sternum fracture (OR 7.96, 95% CI 1.16-54.79; p = 0.035), pre-admission desaturation (OR 0.96; 95% CI 0.77-0.96; p = 0.009) and the number of thoracic tube maintenance days (OR 1.22; 95% CI 1.09-1.37; p = 0.0005). The number of tubes placed and the 1° rib fracture were both significantly associated with the necessity of surgical treatment of RH (2 vs. 1, p = 0.004; 40% vs. 0%; p = 0.001). The risk of developing an RH in thoracic trauma should not be underestimated. Variables related to RH must be taken into account in order to schedule a proper follow-up after trauma.

Keywords: acute care surgery; hemothorax; retained hemothorax; thoracic surgery; thoracic trauma; trauma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow-chart—sHTX (simple hemothorax); rHTX (retained hemothorax).
Figure 2
Figure 2
(A) SpO2 ROC Curve; (B) patients’ distribution based on pre-admission SpO2.
Figure 3
Figure 3
(A) No TT duration days ROC curve; (B) patients’ distribution based on No TT duration days.
See this image and copyright information in PMC

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