Publication: Reevaluating routine chest X-rays after chest tube removal in traumatic pneumothorax
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Issued Date
2026-01-01
Resource Type
ISSN
19997086
eISSN
19997094
Scopus ID
2-s2.0-105028859025
Journal Title
Journal of Emergency Medicine Trauma and Acute Care
Volume
2026
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Emergency Medicine Trauma and Acute Care Vol.2026 No.1 (2026)
Suggested Citation
Prakorbtham C., Tingle C., Prohmpanyanant N., Saengpongpaew P., Boonsinsukh T. Reevaluating routine chest X-rays after chest tube removal in traumatic pneumothorax. Journal of Emergency Medicine Trauma and Acute Care Vol.2026 No.1 (2026). doi:10.5339/jemtac.2026.9 Retrieved from: https://hdl.handle.net/20.500.14740/55322
Author's Affiliation
Corresponding Author(s)
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Abstract
Background: Chest trauma patients often require chest tube insertion to re-expand their lungs. While routine chest X-rays are commonly performed after tube removal to detect complications, their necessity is debated due to concerns about unnecessary radiation, costs, and prolonged hospitalization. Objective: This study aimed to evaluate the necessity of routine chest radiographs following chest tube removal in patients with traumatic pneumothorax by examining the incidence of abnormal post-removal findings and their clinical relevance. Materials and Methods: The medical records of traumatic patients at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, from June 2020 to May 2023 were retrospectively reviewed. We enrolled patients who underwent chest tube insertion. Exclusion criteria included transfer to another hospital, death during admission, persistent mechanical ventilation at the time of tube removal, or Glasgow Coma Scale (GCS) score <8. Results: Among the 207 patients analyzed, 82.1% were male, with a mean age of 43.4 years. Blunt trauma was the predominant mechanism of injury (94.7%), most often resulting in multiple organ injuries (52.7%). The median duration of chest tube placement was 6 days. Abnormal chest radiographs following chest tube removal were observed in 6.3% of patients. Among these, 69.2% presented symptoms such as chest pain, dyspnea, or hypoxemia. Overall, chest tube reinsertion was required in only 1.4% of all patients (n = 3), all of whom were both symptomatic and had abnormal radiographic findings. Clinical symptoms were the only independent predictor of both abnormal chest X-ray findings and chest tube reinsertion (P < 0.001). Conclusion: Routine imaging after chest tube removal may be unnecessary in asymptomatic trauma patients. A symptom-guided approach appears safe and effective, reducing unnecessary imaging and resource use without compromising patient safety. These findings should be interpreted with caution, given the study’s limitations.