ANALYSIS OF TUBE THORACOSTOMY PERFORMED BY PULMONOLOGISTS AT A TEACHING HOSPITAL

Study objective: To evaluate all tube thoracostomies (TTs) done by pul monary/critical care fellows and attending physicians in the Medical U niversity of South Carolina's health-care system documenting patient d emographics, indication for placement, size and characteristics of the tube, and associated problems. Design: Prospective. Setting: Universi ty health-care system, including a university hospital, a Veterans Aff airs hospital, and a county hospital. Patients: All adult patients req uiring consultation by a member of the pulmonary/critical care staff f or a tube thoracostomy. Results: One hundred twenty-six tube thoracost omies were performed over a 24-month period in 91 patients, The most c ommon initial indication for a TT was pneumothorax (69/103, 67%). Over all mortality in the patient population was 35% (32/91). Early problem s (<24 hours following placement) occurred in 3% (4/126); late problem s (>24 h after placement) occurred in 8% (10/126). Problems occurred i n 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 p erformed by pulmonologists with relatively few associated problems.