Outcomes of Pigtail Catheter Placement versus Chest Tube Placement in Adult Thoracic Trauma Patients: A Systematic Review and Meta-Analysis

Authors

George Beeton, University of North Texas Health Science Center
Micah Ngatuvai, Nova Southeastern UniversityFollow
Tessa Breeding, Nova Southeastern UniversityFollow
Ryan Andrade, A.T. Still University School of Osteopathic Medicine
Ruth Zagales, Florida International University
Areeba Khan, Nova Southeastern University
Radleigh Santos, Nova Southeastern UniversityFollow
Adel Elkbuli, Orlando Regional Medical Center

Document Type

Article

Publication Date

6-20-2023

Publication Title

The American Surgeon

Keywords

pigtail catheter, chest tube, thoracic trauma, trauma outcomes

ISSN

1555-9823

Volume

89

Issue/No.

6

First Page

2743

Last Page

2754

Abstract

Introduction

A debate currently exists regarding the efficacy of pigtail catheters vs chest tubes in the management of thoracic trauma. This meta-analysis aims to compare the outcomes of pigtail catheters vs chest tubes in adult trauma patients with thoracic injuries.

Methods

This systematic review and meta-analysis were conducted using PRISMA guidelines and registered with PROSPERO. PubMed, Google Scholar, Embase, Ebsco, and ProQuest electronic databases were queried for studies comparing the use of pigtail catheters vs chest tubes in adult trauma patients from database inception to August 15th, 2022. The primary outcome was the failure rate of drainage tubes, defined as requiring a second tube placement or VATS, unresolved pneumothorax, hemothorax, or hemopneumothorax requiring additional intervention. Secondary outcomes were initial drainage output, ICU-LOS, and ventilator days.

Results

A total of 7 studies satisfied eligibility criteria and were assessed in the meta-analysis. The pigtail group had higher initial output volumes vs the chest tube group, with a mean difference of 114.7 mL [95% CI (70.6 mL, 158.8 mL)]. Patients in the chest tube group also had a higher risk of requiring VATS vs the pigtail group, with a relative risk of 2.77 [95% CI (1.50, 5.11)].

Conclusions

In trauma patients, pigtail catheters rather than chest tubes are associated with higher initial output volume, reduced risk of VATS, and shorter tube duration. Considering the similar rates of failure, ventilator days, and ICU length-of-stay, pigtail catheters should be considered in the management of traumatic thoracic injuries.

Study Type

Systematic Review and meta-analysis.

Comments

© The Author(s) 2023.

NSUWorks Citation

Beeton, George; Ngatuvai, Micah; Breeding, Tessa; Andrade, Ryan; Zagales, Ruth; Khan, Areeba; Santos, Radleigh; and Elkbuli, Adel, "Outcomes of Pigtail Catheter Placement versus Chest Tube Placement in Adult Thoracic Trauma Patients: A Systematic Review and Meta-Analysis" (2023). Mathematics Faculty Articles. 356.
https://nsuworks.nova.edu/math_facarticles/356

ORCID ID

0000-0002-8194-5502

DOI

10.1177/00031348231157809