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Erschienen in:
12.12.2022 | Correction
Correction: Association between three prehospital thoracic decompression techniques by physicians and complications: a retrospective, multicentre study in adults
Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2023
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The original version of this article unfortunately contained a mistake. The presentation of Tables 3, 4 and 5 were incorrect. The corrected Tables 3, 4 and 5 are given below.
Table 3
Complications by decompression type per patient
|
Complication type
|
Decompression type, complication rate, %
|
P value
|
Details
|
||
|---|---|---|---|---|---|
|
Insertional complications
|
ND
|
0/9
|
(0)
|
0.318
|
Finger thoracostomy
|
|
FT
|
4/149
|
(2.7)
|
Wound bleeding in 2 patients, 1 (with prior lung sliding present, and co-existing severe head injury) required surgical ligation for resolution of ongoing haemodynamic instability
Tip of non-sterile glove finger found on lung at thoracoscopy (Supplementary Fig. 4)
Drain inserted in the ED through a prehospital FT resulted in iatrogenic splenic injury
Tube thoracostomy
4 intra-parenchymal placements (2 ETT, 2 Frontline)
Glove finger-tip attached to the drain identified at thoracoscopy (Argyle)
Drain inserted through the 5th ICS, MAL but positioned in avulsed liver in presence of diaphragm rupture (Frontline)
|
||
|
TT
|
6/97
|
(6.2)
|
|||
|
Total
|
10/255
|
(3.9)
|
|||
|
Positional complications
|
ETT
|
0/16
|
(0)
|
0.025
|
4 extra- pleural placements (all Argyle)
|
|
Argyle
|
19/65
|
(29.2)
|
7 inserted too deeply (all Argyle)
|
||
|
Frontline
|
2/16
|
(12.5)
|
3 dislodged / partially dislodged (2 Argyle, 1 Frontline)
|
||
|
Total TT
|
2/16
|
(21.6)
|
|||
|
3 kinked (2 Argyle, 1 Frontline)
|
|||||
|
4 position issue not further stated (all Argyle)
|
|||||
|
Infective complications
|
ND
|
0/9
|
(0)
|
0.850
|
5 empyema (3 FT, 2 Argyle)
|
|
FT
|
4/149
|
(2.7)
|
1 wound infection (FT)
|
||
|
TT
|
2/97
|
(2.1)
|
|||
|
TT
|
6/255
|
(2.4)
|
|||
|
Recurrent tension physiologya
|
ND
|
0/9
|
(0)
|
< 0.001
|
Finger thoracostomy
15 of 21 recurrent tension physiology patients had moderate / severe TBI (AIS ≥ 3), 5 of which had recurrent tension physiology 2 or more times
Tube thoracostomy
2 patients (both Argyle) had large air leaks requiring ED placement of two or more additional drains, with 1 undergoing urgent thoracotomy. 1 non-functioning Argyle drain required replacement in the ED
|
|
FT
|
21/151
|
FT
|
|||
|
TT
|
3/94
|
(3.2)
|
|||
|
FT & TT
|
1/1
|
(100)
|
|||
|
Total
|
25/255
|
(9.8)
|
|||
|
Overall complications
|
ND
|
0/9
|
(0)
|
0.009
|
|
|
FT
|
28/149
|
(18.8)
|
|||
|
TT
|
32/97
|
(33.0)
|
|||
|
Total
|
60/255
|
(23.5)
|
|||
Table 4
Sensitivity analysis of relative risk (RR, 95% CI) of overall complication by decompression technique in 246 patients
|
Variable
|
Overall complications (n, %)
|
Unadjusted RR (95% CI)
|
P value
|
Adjusted RR (95% CI)
|
P value
|
|---|---|---|---|---|---|
|
Decompression technique
|
|||||
|
Tube thoracostomy
Finger thoracostomy
|
32 (33.0)
28 (18.8)
|
1.00
0.57 (0.37–0.88)
|
0.012
|
1.00
0.58 (0.33–1.03)
|
0.061
|
|
Decompression location
|
|||||
|
Unilateral
Bilateral
|
31 (25.4)
29 (23.4)
|
1.00
0.92 (0.59–1.43)
|
0.713
|
1.00
1.16 (0.74–1.80)
|
0.517
|
|
Obesity
|
|||||
|
No
Yes
|
54 (23.8)
6 (31.6)
|
1.00
1.33 (0.66–2.68)
|
0.430
|
1.00
1.11 (0.51–2.41)
|
0.790
|
|
HEMS service provider
|
|||||
|
Greater Sydney area HEMS
Hunter retrieval service
CareFlight rapid response HEMS
|
39 (21.8)
16 (32.7)
5 (27.8)
|
1.00
1.50 (0.92–2.45)
1.27 (0.57–2.83)
|
0.105
0.550
|
1.00
1.01 (0.55–1.84)
0.95 (0.40–2.25)
|
0.973
0.901
|
|
CPR on scene or in transit
|
|||||
|
No
Yes
|
59 (26.7)
1 (4.0)
|
1.00
0.15 (0.02–1.04)
|
0.055
|
1.00
0.16 (0.02–1.05)
|
0.056
|
|
Prolonged scene time (Minutes)
|
|||||
|
No (< 60)
Yes (≥ 60)
|
45 (23.1)
15 (29.4)
|
1.00
1.27 (0.78–2.10)
|
0.339
|
1.00
1.09 (0.65–1.83)
|
0.751
|
Table 5
Unadjusted and adjusted 80th percentile (95% CI) scene times (minutes) using quantile regression in 246 patients
|
N (%)
|
Unadjusted 80th percentile (95% CI)
|
P value
|
Adjusted 80th percentile (95% CI)
|
P value
|
|
|---|---|---|---|---|---|
|
Decompression technique
|
|||||
|
Tube thoracostomy
Finger thoracostomy
|
97 (39.4)
149 (60.6)
|
60 (53–67)
59 (52–66)
|
0.843
|
63 (56–70)
56 (49–64)
|
0.197
|
|
Decompression location
|
|||||
|
Unilateral
Bilateral
|
122 (49.6)
124 (50.4)
|
58 (50–66)
65 (59–71)
|
0.158
|
57 (48–66)
61 (55–66)
|
0.470
|
|
Obesity
|
|||||
|
No
Yes
|
227 (92.3)
19 (7.7)
|
59 (53–65)
67 (49–85)
|
0.401
|
58 (53–64)
67 (54–80)
|
0.190
|
|
HEMS service provider
|
|||||
|
Greater Sydney area HEMS
Hunter retrieval service
CareFlight rapid response HEMS
|
179 (72.8)
49 (19.9)
18 (7.3)
|
60 (54–66)
70 (60–80)
41 (28–54)
|
0.091
0.011
|
60 (54–66)
61 (50–72)
38 (26–50)
|
0.872
0.003
|
|
CPR on scene or in transit
|
|||||
|
No
Yes
|
221 (89.8)
25 (10.2)
|
62 (57–67)
29 (14–44)
|
< 0.001
|
62 (57–67)
31 (17–45)
|
< 0.001
|