{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:31Z","timestamp":1777448611880,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,1]]},"abstract":"\n Introduction<\/jats:title>\n The identification and treatment of traumatic pneumothorax (PTX) has long been a focus of bedside imaging in the trauma patient. While the emergence of bedside ultrasound (BUS) provides an opportunity for earlier detection, the need for tube thoracostomy (TT) based on bedside imaging, including BUS and supine AP chest X-ray (CXR) is less established in the medical literature.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective data from 2017 to 2020 were collected of all adult trauma activations at a level 1 rural trauma facility. Every adult patient included in this study received a CXR and BUS (eFast) upon arrival. The need for TT was determined by the emergency medicine attending or the trauma surgery attending evaluating the patient. McNemar\u2019s chi-squared test and conditional logistic regression analysis were performed comparing BUS, CXR, and the combination of BUS and CXR findings for the need for TT. Subgroup analyses were performed comparing BUS, CXR, and the combination of BUS and CXR for the detection of PTX compared to CT scan.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 12,244 patients who underwent trauma activation during this timeframe, 602 were included in the study. 74.9% were males with an age range of 36-63\u00a0years. Of the 602 patients, 210 received TT. Positive PTX was recorded with BUS in 128 (21%) patients with 16 false negatives (FNs) and 98 false positives (FPs), 100 (17%) PTX were identified with CXR with 114 FNs and 4 FPs, and 72 (11.9%) were noted on both CXR and BUS with 140 FNs and 2 FPs. The odds ratio of TT placement was 22 times with positive BUS alone ( P < .0001, 95% CI: 10.9-43.47), 47 times with positive CXR alone ( P < .0001, 95% CI: 16.99-127.5), and 70 times with both positive CXR and BUS ( P < .0001, 95% CI: 17.08-288.4).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A positive finding of PTX on BUS combined with CXR is more indicative of the need for TT in the trauma patient when compared with BUS or CXR alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348231192061","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T23:01:37Z","timestamp":1690498897000},"page":"23-27","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Chest X-Ray Remains a Vital Component Prior to Tube Thoracostomy"],"prefix":"10.1177","volume":"90","author":[{"given":"Cody","family":"Moore","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Oury","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma, Surgical Critical Care and Acute Care Surgery, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Denne","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Quedado","sequence":"additional","affiliation":[{"name":"Director of Research and Scholarship, West Virginia University School of Medicine, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Fang","sequence":"additional","affiliation":[{"name":"West Virginia University Clinical & Translational Science Institute, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Bardes","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA"},{"name":"Department of Surgery, Division of Trauma, Surgical Critical Care and Acute Care Surgery, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"bibr1-00031348231192061","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2007.02.004"},{"key":"bibr2-00031348231192061","first-page":"58","volume-title":"Rosen\u2019s Emergency Medicine: Concepts and Clinical Practice","author":"Eckstein M","year":"2014"},{"key":"bibr3-00031348231192061","volume-title":"Advanced Trauma Life Support\u00ae Student Course Manual","author":"ATLS Committee","year":"2012","edition":"9"},{"issue":"7","key":"bibr4-00031348231192061","first-page":"CD013031","volume":"7","author":"Chan KK","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr5-00031348231192061","doi-asserted-by":"publisher","DOI":"10.1186\/1752-2897-4-12"},{"issue":"1","key":"bibr6-00031348231192061","first-page":"7","volume":"17","author":"Wilkerson RG","year":"2010","journal-title":"Acad Emerg Med"},{"key":"bibr7-00031348231192061","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199906000-00001"},{"key":"bibr8-00031348231192061","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00478-5"},{"issue":"5","key":"bibr9-00031348231192061","first-page":"5","volume":"70","author":"Moore FO","year":"2011","journal-title":"J 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