{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:12:11Z","timestamp":1790997131513,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Thoracic trauma occurs in 20\u201325% 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\u201354.79; p = 0.035), pre-admission desaturation (OR 0.96; 95% CI 0.77\u20130.96; p = 0.009) and the number of thoracic tube maintenance days (OR 1.22; 95% CI 1.09\u20131.37; p = 0.0005). The number of tubes placed and the 1\u00b0 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.<\/jats:p>","DOI":"10.3390\/jpm12101570","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T01:41:58Z","timestamp":1664156518000},"page":"1570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk Factors for Retained Hemothorax after Trauma: A 10-Years Monocentric Experience from First Level Trauma Center in Italy"],"prefix":"10.3390","volume":"12","author":[{"given":"Marta","family":"Rossmann","sequence":"first","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-2678","authenticated-orcid":false,"given":"Michele","family":"Altomare","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Pezzoli","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Abruzzese","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Spota","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vettorello","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5453-8901","authenticated-orcid":false,"given":"Stefano","family":"Cioffi","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Virdis","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4512-6243","authenticated-orcid":false,"given":"Roberto","family":"Bini","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-2109","authenticated-orcid":false,"given":"Osvaldo","family":"Chiara","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Pathophysiology and Transplants, State University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[{"name":"General Surgery and Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Pathophysiology and Transplants, State University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"ref_1","unstructured":"Lecky, F.E., Bouamra, O., Woodford, M., Alexandrescu, R., and O\u2019Brien, S.J. (2010). Damage Control Management in the Polytrauma Patient, Springer New York."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0039-6109(16)41131-X","article-title":"Nonpenetrating Thoracic Injuries","volume":"57","author":"Wilson","year":"1977","journal-title":"Surg. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/TA.0b013e31820b5c31","article-title":"Practice Management Guidelines for Management of Hemothorax and Occult Pneumothorax","volume":"70","author":"Mowery","year":"2011","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1097\/TA.0000000000003180","article-title":"The small (14 Fr) percutaneous catheter (P-CAT) versus large (28\u201332 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial","volume":"91","author":"Kulvatunyou","year":"2021","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00063198-199807000-00012","article-title":"Thoracoscopy in the management of hemothorax and retained blood after trauma","volume":"4","author":"Carrillo","year":"1998","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00068-015-0604-y","article-title":"Predictors of retained hemothorax after trauma and impact on patient outcomes","volume":"43","author":"Scott","year":"2017","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/TA.0000000000002881","article-title":"Predictors of retained hemothorax in trauma: Results of an Eastern Association for the Surgery of Trauma multi-institutional trial","volume":"89","author":"Prakash","year":"2020","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.injury.2007.06.001","article-title":"The risk factors and management of posttraumatic empyema in trauma patients","volume":"39","author":"Eren","year":"2008","journal-title":"Injury"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1097\/TA.0b013e31825c1616","article-title":"Development of posttraumatic empyema in patients with retained hemothorax","volume":"73","author":"DuBose","year":"2012","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1155\/2008\/918951","article-title":"Residual Hemothorax after Chest Tube Placement Correlates with Increased Risk of Empyema Following Traumatic Injury","volume":"15","author":"Holevar","year":"2008","journal-title":"Can. Respir. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1097\/TA.0000000000001370","article-title":"The use of an evidence-based algorithm for patients with traumatic hemothorax reduces need for additional interventions","volume":"82","author":"Dennis","year":"2017","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5507\/bp.2012.042","article-title":"Quantification of pleural effusion on CT by simple measurement","volume":"158","author":"Hazlinger","year":"2014","journal-title":"Biomed. Pap."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0895-4356(94)90129-5","article-title":"Validation of a combined comorbidity index","volume":"47","author":"Charlson","year":"1994","journal-title":"J. Clin. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1097\/00005373-199712000-00009","article-title":"A Modification of the Injury Severity Score That Both Improves Accuracy and Simplifies Scoring","volume":"43","author":"Osler","year":"1997","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s00068-010-0064-3","article-title":"Risk factors associated with the development of post-traumatic retained hemothorax","volume":"37","author":"Villegas","year":"2011","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/0002-9610(84)90438-0","article-title":"Reevaluation of early evacuation of clotted hemothorax","volume":"148","author":"Coselli","year":"1984","journal-title":"Am. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jss.2013.08.025","article-title":"Sternal fracture\u2014An analysis of the National Trauma Data Bank","volume":"186","author":"Yeh","year":"2014","journal-title":"J. Surg. Res."},{"key":"ref_18","first-page":"379","article-title":"Sternal fracture with or without associated injuries. Assessment of the difference in the diagnosis, management and complications. Eighteen years of experience","volume":"77","author":"Metaxas","year":"2006","journal-title":"Ann. Ital. Chir."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s00464-007-9378-6","article-title":"Best timing for thoracoscopic evacuation of retained post-traumatic hemothorax","volume":"22","year":"2008","journal-title":"Surg. Endosc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1007\/s00068-009-9119-8","article-title":"The Epidemiology of Traumatic Hemothorax in a Level I Trauma Center: Case for Early Video-assisted Thoracoscopic Surgery","volume":"36","author":"MacLeod","year":"2010","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/S0003-4975(97)00173-2","article-title":"The Role of Thoracoscopy in the Management of Retained Thoracic Collections After Trauma","volume":"63","author":"Heniford","year":"1997","journal-title":"Ann. Thorac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/S0003-4975(97)00899-0","article-title":"Early Evacuation of Traumatic Retained Hemothoraces Using Thoracoscopy: A Prospective, Randomized Trial","volume":"64","author":"Meyer","year":"1997","journal-title":"Ann. Thorac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.amjsurg.2020.11.032","article-title":"Management of simple and retained hemothorax: A practice management guideline from the Eastern Association for the surgery of Trauma","volume":"221","author":"Patel","year":"2021","journal-title":"Am. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1007\/s00268-017-4420-x","article-title":"Early management of retained hemothorax in blunt head and Chest trauma","volume":"42","author":"Huang","year":"2018","journal-title":"World J. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/10\/1570\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:38:18Z","timestamp":1760143098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/10\/1570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":24,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jpm12101570"],"URL":"https:\/\/doi.org\/10.3390\/jpm12101570","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,23]]}}}