Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital

Study objective: To evaluate all tube thoracostomies (TTs) done by pulmonary/critical care fellows and attending physicians in the Medical University of South Carolina's health-care system documenting patient demographics, indication for placement, size and characteristics of the tube, and associated problems. Design: Prospective. Setting: University health-care system, including a university hospital, a Veterans Affairs hospital, and a county hospital. Patients: All adult patients requiring consultation by a member of the pulmonary/critical care staff for a tube thoracostomy. Results: One hundred twenty-six tube thoracostomies were performed over a 24-month period in 91 patients, The most common initial indication for a TT was pneumothorax (69/103, 67%). Overall mortality in the patient population was 35% (32/91). Early problems (<24 hours following placement) occurred in 3% (4/126); late problems (>24 h after placement) occurred in 8% (10/126). Problems occurred in 36% (4/11) of small-bore tube placements vs 9% (10/115) of standard TT placements (p=0.02). Conclusions: Tube thoracostomy can be safely performed by pulmonologists with relatively few associated problems.