{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:30:20Z","timestamp":1790850620092,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T00:00:00Z","timestamp":1515110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T00:00:00Z","timestamp":1515110400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hemothorax is most commonly resulted from a closed chest trauma, while a tube thoracostomy (TT) is usually the first procedure attempted to treat it. However, TT may lead to unexpected results and complications in some cases. The advantage of thoracic ultrasound (TUS) over a physical examination combined with chest radiograph (CXR) for diagnosing hemothorax<jats:sup>1<\/jats:sup> has been proposed previously. However, its benefits in terms of avoiding non\u2010therapeutic TT have not yet been confirmed. Therefore, this study is aimed to evaluate the severity of hemothorax in blunt chest trauma patients by using TUS in order to avoid non\u2010therapeutic TT in stable cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data from 46,036 consecutive patient visits to our trauma center over a four\u2010year period were collected, and those with blunt chest trauma were identified. Patients who met any of the following criteria were excluded: transferred from another facility, with an abbreviated injury scale (AIS) score \u2265 2 for any region except the chest region, with a documented finding of tension pneumothorax or pneumothorax &gt;10%, younger than 16 years old and with indications requiring any non\u2010thoracic major operation. The decision to perform TT for those patients in the non\u2010TUS group was made on the basis of CXR findings and clinical symptoms. The continuous data were analyzed by using the two\u2010tailed Student\u2019s <jats:italic>t<\/jats:italic> test, and the discrete data were analyzed by Chi\u2010square test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 84 patients met the criteria for inclusion in the final analysis, with TT having been performed on 42 (50%) of those patients. The mean volume of the drainage amount was 860\u00a0ml after TT. The TT drainage was less than 500\u00a0ml in 12 patients in the non\u2010TUS group (40%), while none was less than 500\u00a0ml in the TUS group (<jats:italic>p<\/jats:italic> = 0.036, Fisher\u2019s exact test). In terms of the positive rate of subsequent effective TT, the sensitivity of TUS was 90% and the specificity was 100%. There were 3 patients with delayed hemothorax: 2 of the 58 (3.6%) in the non\u2010TUS group and 1 of 26 (4.5%) in the TUS group (<jats:italic>p<\/jats:italic> &gt; 0.05, Fisher\u2019s exact test). The hospital length of stay in the non\u2010TUS group with non\u2010therapeutic TT was significantly longer than in the TUS group without TT (8.2 vs. 5.4\u00a0days, <jats:italic>p<\/jats:italic> = 0.018). There were no other major complications or deaths in either group during the 90\u2010day follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the case of blunt trauma, TUS can rapidly and accurately evaluate hemothorax to avoid TT in patients who may not benefit much from it. As a result, the rate of non\u2010therapeutic TT can be decreased, and the influence on shortening hospital length of stay may be further evaluated with prospective controlled study.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4417-5","type":"journal-article","created":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T15:48:59Z","timestamp":1515167339000},"page":"2054-2060","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Benefit of Ultrasound in Deciding Between Tube Thoracostomy and Observative Management in Hemothorax Resulting from Blunt Chest Trauma"],"prefix":"10.1002","volume":"42","author":[{"given":"Meng\u2010Hsuan","family":"Chung","sequence":"first","affiliation":[{"name":"Division of Trauma, Emergency Department Taipei\u2010Veterans General Hospital No. 201, Sec. 2, Shih\u2010Pai Road 112 Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Yuan","family":"Hsiao","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai\u2010Shin","family":"Nian","sequence":"additional","affiliation":[{"name":"Department of Nursing Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Chia","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Department Taipei\u2010Veterans General Hospital No. 201, Sec. 2, Shih\u2010Pai Road 112 Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Department Taipei\u2010Veterans General Hospital No. 201, Sec. 2, Shih\u2010Pai Road 112 Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Szu","family":"Wen","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Department Taipei\u2010Veterans General Hospital No. 201, Sec. 2, Shih\u2010Pai Road 112 Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin\u2010Chin","family":"Shih","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Department Taipei\u2010Veterans General Hospital No. 201, Sec. 2, Shih\u2010Pai Road 112 Taipei Taiwan"},{"name":"Institute of Emergency and Critical Care Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David 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