Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome

Rizer, Nicholas; Smood, Benjamin; Mergler, Blake; Sperry, Alexandra; Bermúdez, C.; Gutsche, Jacob T.; Usman, Asad

doi:10.1016/j.xjon.2022.03.008

Cited by 5 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of tube thoracostomy in COVID-19 critically-ill patients is estimated at 4.0%. 11 This is significantly higher than the prevalence of tube thoracostomy in all COVID-19-positive patients in the Philippine General Hospital, which is 1.05%. A total of 34 patients satisfied the inclusion criteria for this retrospective study, among whom 13 (38.24%) expired.…”

Section: Discussionmentioning

confidence: 77%

“…Furthermore, they identified that delayed development of pleural disease requiring tube thoracostomy was associated with decreased survival. 11 …”

Section: Discussionmentioning

confidence: 99%

“…In the published literature, pneumothorax is the leading indication for tube thoracostomy in COVID-19-afflicted patients, with an incidence as high as 7.6%. 11 However, pneumothorax in COVID-19 pneumonia is not in itself an independent poor prognostic factor as suggested by retrospective studies by Martinelli et al and Wang et al 16 , 17 The rationalization for such a high incidence rate of pneumothorax in COVID-19 infection is backed up by autopsies of deceased COVID-19 patients revealing diffuse alveolar damage with perivascular T-cell infiltration, diffuse pulmonary vessel microangiopathy and thrombosis depicting noncompliant lungs, combined with the need for positive pressure ventilation. 6 , 12 The incidence of pneumothorax in adult COVID-19-positive patients admitted to the Philippine General Hospital is 3.09% only.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of Tube Thoracostomies in COVID-19 Patients: A Retrospective Cohort Study in the University of the Philippines - Philippine General Hospital COVID-19 Referral Center

2023

Acta Med Philipp

View full text Add to dashboard Cite

Objective To describe the treatment outcomes of patients who underwent tube thoracostomy for pleural complications in patients with COVID-19 and determine the association between patient profile and treatment outcomes. Methods A single-institution retrospective review of patients who underwent tube thoracostomy for complications of COVID-19 infection in the University of the Philippines - Philippine General Hospital (UP-PGH) from March 30, 2020, to March 31, 2021, was performed. These patients’ demographic and clinical profiles were evaluated using median, frequencies, and percentages. The association between patient profile, and mortality and reintervention rates was assessed using univariable Cox proportional hazards regression analysis. Results Thirty-four (34) of 3,397 patients (1.00%) admitted for COVID-19 pneumonia underwent tube thoracostomy. Of these, 34, 47.06% were male, 52.94% were female, the median age was 51.5 years old, 85.29% had comorbid conditions, and 29.41% had a previous or ongoing tuberculous infection. The most common indication for tube thoracostomy was pleural effusion (61.76%), followed by pneumothorax (29.41%), and pneumo-hydrothorax (8.82%). The mortality rate was 38.24%, and the reintervention rate was 14.71%. Intubated patients had 14.84 times higher mortality hazards than those on room air. For every unit increase in procalcitonin levels, the mortality hazards were increased by 1.06 times. Conclusion An increasing level of oxygen support on admission and a level of procalcitonin were directly related to mortality risk in COVID-19 patients who underwent tube thoracostomy for pleural complications. There is insufficient evidence to conclude that patient-related, COVID-19 pneumonia-related, and procedure-related factors included in this study were significantly associated with reintervention risk.

show abstract

Section: Discussionmentioning

confidence: 77%

“…Furthermore, they identified that delayed development of pleural disease requiring tube thoracostomy was associated with decreased survival. 11 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Tube Thoracostomies in COVID-19 Patients: A Retrospective Cohort Study in the University of the Philippines - Philippine General Hospital COVID-19 Referral Center

2023

Acta Med Philipp

View full text Add to dashboard Cite

show abstract

“…In one retrospective observational cohort study, performed within the University of Pennsylvania Health System and published in June 2022, patients were divided into two cohorts based on the presence/absence of at least one tube thoracostomy during the first COVID-related admission to the ICU. Patients who received chest tubes had increased mortality, longer duration of mechanical ventilation, and overall hospital and ICU length of stay compared with those patients who did not develop a pneumothorax requiring chest tube placement ( 11 ). Authors of the same study recognized the necessity for a tube thoracostomy as a negative prognostic sign.…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Experience on the Treatment Outcomes of Patients with COVID-19-Pleural Disorders: Lessons for the Future

Pasalic,

Pilav,

Maric

et al. 2023

Med Arch

View full text Add to dashboard Cite

Background: Pleural disorders in novel coronavirus disease 2019 (COVID-19), responsible for the deaths of more than 6.7 million people worldwide, are relatively uncommon and underappreciated findings. The severity of the pleural disease in these patients correlates with the treatment outcome and overall prognosis. Objective: We aim to review our experience with treatment modalities and prognosis in 45 patients with COVID-19, who were treated at our Clinic between April 2020 and October 2021. Methods: We conducted a retrospective, single-center, cross-sectional study. Demographic data, the type of thoracosurgical intervention(s), and treatment outcome for 45 patients included in this study were recorded for every patient. We analyzed the type and number of treatment modalities according to the pleural disorder, and the outcome of the treatment. Results: Pneumothorax was the most common COVID-19-related pleural disorder, followed by the pleural effusion. Tube thoracostomy was the mainstay of treatment, performed in 84.4% of patients with unilateral pleural complications. In total, 20% of our patients were on mechanical ventilation, and all of them had a fatal outcome. We found statistical significance in comparison to the percentage of fatal outcomes between patients treated with and without mechanical ventilation (p=0.000). Conclusion: COVID-19-related pleural disorders are prognostic markers of disease progression. Mechanically ventilated patients who require tube thoracostomy have an unfavorable prognosis.

show abstract

Predictive Factors for Length of Hospital Stay and Intensive Care Admission in Patients With Rib Fractures

Fernández-González,

González-Quevedo,

Zúñiga

et al. 2023

Archivos de Bronconeumología

View full text Add to dashboard Cite

Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome

Cited by 5 publications

References 33 publications

Outcomes of Tube Thoracostomies in COVID-19 Patients: A Retrospective Cohort Study in the University of the Philippines - Philippine General Hospital COVID-19 Referral Center

Outcomes of Tube Thoracostomies in COVID-19 Patients: A Retrospective Cohort Study in the University of the Philippines - Philippine General Hospital COVID-19 Referral Center

A Single-Center Experience on the Treatment Outcomes of Patients with COVID-19-Pleural Disorders: Lessons for the Future

Predictive Factors for Length of Hospital Stay and Intensive Care Admission in Patients With Rib Fractures

Contact Info

Product

Resources

About