2Department of General Surgery, Bangalore Medical College and Research Institute, Bangalore, India Original Article Corresponding DOI : 10.26663/cts.2025.019 Viewed : 8 - Downloaded : 10 Background: Hemothorax is a common consequence of blunt chest trauma. A subset progresses to complicated hemothorax requiring repeat procedures. This study aimed to identify predictors of complicated hemothorax.
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.
Keywords : hemothorax, blunt chest trauma, video-assisted thoracoscopic surgery, empyema, chest tubes