Complications related to tube thoracostomy in Southwest Finland hospital district between 2004 and 2014

Abstract

Background and Aims: The purpose of this study was to describe the frequency and types of complications after tube thoracostomy among all patients treated with tube thoracostomy for both traumatic and non-traumatic indications. Material and Methods: Retrospective register-based study of patients treated with tube thoracostomy between the years 2004 and 2014 in a university hospital. Results: In total, 1808 patients who had undergone tube thoracostomy were identified, complete data on tube thoracostomy treatment was available for 1169 patients. A total of 233 (19.9%) patients had 289 complications, 284 (98.3%) were positional resulting in tube malfunction. In 84 (7.2%) patients, malposition of the tube resulted in need for non-urgent operative treatment. There were 103 in-hospital deaths, but none due to tube thoracostomy complications. Empyema as a treatment indication was more frequent in patients with complications (15.9% vs 6.8%, p < 0.001) as was diabetes (21.9% vs 13.2%, p = 0.001). The likelihood of complications was lower with CH16 tubes (odds ratio 0.22, p < 0.001) and higher in diabetics (odds ratio 1.86, p = 0.001). Conclusion: Tube thoracostomy is a common procedure and complications occur in 19.9% of patients. Serious complications caused by the chest tube placement, however, are extremely rare. Complications were most common in patients treated for empyema and diabetics. Small CH16 tubes were associated with a lower incidence of complications.