Materials and Methods: A retrospective cohort study was conducted, including 60 patients with blunt chest trauma and hemothorax managed at a tertiary care center. Patients were grouped into uncomplicated (n = 30) and complicated hemothorax (n = 30, requiring additional procedures). Logistic regression was performed to identify predictors.
Results: On univariate analysis, delay in ICD placement >3 days (OR 5.09, p = 0.015) and loculated/septated collections (OR 21.1, p < 0.001) were associated with complicated hemothorax. In multivariable analysis, only loculated/septated collections remained an independent predictor (adjusted OR 26.5, p = 0.006).
Conclusions: Loculated collections are the strongest predictor of complicated hemothorax. Early identification of septated/loculated collections on imaging should prompt timely surgical referral, preferably VATS, to reduce morbidity and minimize repeat procedures. In delayed-presentation trauma with loculated collections or comorbidities, early surgical intervention should be considered as simple chest drainage is often insufficient.
