{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T19:02:18Z","timestamp":1773687738678,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Traumatic pneumothoraces (T\u2010PTXs) are traditionally managed with an intercostal catheter (ICC), despite little evidence for this. Success with conservative management of primary spontaneous PTX has been demonstrated, and our ED has adopted a conservative approach where safe for all PTX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed all T\u2010PTXs at our institution over a 7\u2010year period to assess outcomes of those conservatively managed and compare with those who received an ICC. A total of 144 cases were identified, 65 managed conservatively and 79 invasively. Each was individually reviewed and variables including demographics, aetiology, smoking\/lung disease history, T\u2010PTX size (apical interpleural distance and hemithorax percentage), length of stay, Revised Trauma Score, Injury Severity Score and delayed intervention\/complications were recorded. Chi\u2010squared, <jats:italic>Z<\/jats:italic>\u2010score, Mann\u2013Whitney <jats:italic>U<\/jats:italic> and <jats:italic>t<\/jats:italic>\u2010tests were used for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean apical interpleural distance was 26.8\u2009mm (95% confidence interval [CI] 22.1\u201329.7\u2009mm) in the conservative group and 49.1\u2009mm (95% CI 41.2\u201357.0\u2009mm) in the ICC group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 for difference between groups). Mean T\u2010PTX percentage 25.9% (95% CI 22.1\u201329.7%) in the conservative group <jats:italic>versus<\/jats:italic> 45.9% (95% CI 39.7\u201350.5%) in the ICC group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 for difference between two groups) and mean Revised Trauma Score 7.4 (conservative) <jats:italic>versus<\/jats:italic> 6.8 (invasive) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). No conservatively managed patient required a delayed intervention for their T\u2010PTX, and 2 of 79 (3%) patients in the ICC group had a complication (one infection, one haemothorax).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data support conservative management of selected T\u2010PTXs and shows a need for a prospective randomised trial to further examine this intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13846","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T23:54:00Z","timestamp":1629935640000},"page":"194-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Conservative management of traumatic pneumothoraces: A retrospective cohort study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-929X","authenticated-orcid":false,"given":"Benjamin C","family":"Gerhardy","sequence":"first","affiliation":[{"name":"Cairns Hospital  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Liebenberg","sequence":"additional","affiliation":[{"name":"Cairns Hospital  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Simpson","sequence":"additional","affiliation":[{"name":"Cairns Hospital  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Advanced Trauma Life Support (ATLS) Student Course Manual","author":"American College of Surgeons","year":"2018"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.13.3.173"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.10.015"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.33"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910775"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.165.5.7572489"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-1433.2003.02833.x"},{"key":"e_1_2_9_9_1","first-page":"13","article-title":"Major trauma and the injury severity score: where should we set the bar?","volume":"51","author":"Palmer C","year":"2007","journal-title":"Annu. Proc. Assoc. Adv. Automot. Med."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.209.2.9807591"},{"key":"e_1_2_9_11_1","first-page":"222","volume-title":"Textbook of Pleural Diseases","author":"Koegelenberg CFA","year":"2016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3402-9"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.13846","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.13846","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.13846","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T17:06:12Z","timestamp":1692983172000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.13846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1111\/1742-6723.13846"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.13846","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,25]]},"assertion":[{"value":"2021-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}