Ahmed K, Al-Hassani A, El-Menyar A, Nabir S, Ahmed MN, Almadani A, Mahmood I, Mekkodathil A, Peralta R, Rizoli S, Al-Thani H. Time to resolution of radiologically detected hemothorax in trauma patients: A retrospective observational study. World J Radiol 2025; 17(4): 105960 [DOI: 10.4329/wjr.v17.i4.105960]
Corresponding Author of This Article
Ayman El-Menyar, Professor, Clinical Medicine, Weill Cornell Medical College, Qatar Foundation-Education City, Doha 24144, Qatar. aymanco65@yahoo.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ayman El-Menyar, Clinical Medicine, Weill Cornell Medical College, Qatar Foundation-Education City, Doha 24144, Qatar
Syed Nabir, Mohamed Nadeem Ahmed, Department of Radiology, Hamad Medical Corporation, Doha 3050, Qatar
Ruben Peralta, Department of Surgery, Universidad Nacional Pedro Henriquez Urena, Santo Domingo 10100, Dominican Republic
Author contributions: Ahmed K and Al-Hassani A designed research and performed research; Nabir S and Nadeem M extracted and analyzed radiological data; Mekkodathil A analyzed data; Ahmed K, Al-Hassani A, Almadani A and Mahmood I wrote the paper, Al-Hassani A, El-Menyar A and Al-Thani H reviewed the manuscript and supervised the project. All authors contributed to the study design, data analysis and interpretation, and manuscript writing, and the final manuscript was approved.
Institutional review board statement: Ethical approval was obtained from the institutional review board (MRC-01-19-473) at the Medical Research Center, Hamad Medical Corporation (HMC), Doha, Qatar.
Informed consent statement: Not applicable for this retrospective study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data are presented in the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayman El-Menyar, Professor, Clinical Medicine, Weill Cornell Medical College, Qatar Foundation-Education City, Doha 24144, Qatar. aymanco65@yahoo.com
Received: February 12, 2025 Revised: March 15, 2025 Accepted: March 26, 2025 Published online: April 28, 2025 Processing time: 69 Days and 22.4 Hours
Abstract
BACKGROUND
Traumatic hemothorax is a common complication of chest trauma; however, the timeline for its resolution, even with chest tube thoracostomy, remains unclear.
AIM
To determine the time to resolution of the hemothorax to ensure safe discharge based on chest radiography (CXR) findings.
METHODS
A retrospective observational study was conducted at Hamad General Hospital, Qatar, from June 2014 to October 2019, including all patients with hemothorax diagnosed via computed tomography (CT) following chest trauma. Based on the initial imaging study, the hemothorax was divided into right, left, and bilateral.
RESULTS
The study included 422 patients. Of the total, 57.82% (n = 244/422) resolved their hemothorax within three days of admission. Among these, 44 patients required chest tube insertion (CTI) and 200 were cleared without it. Between days 3 and 7, an additional 16.83% (n = 71 /422) of cases were resolved, of which 28 required chest tubes. By days 8 to 14, another 11.37% (n = 48/422) were cleared, with 15 patients requiring chest tubes. After 14 days, 13.98% (n = 59/422) of patients still had hemothorax, 14 of whom required CTI.
CONCLUSION
This study showed that a subset of patients continued to experience retained hemothorax despite early tube thoracostomy. Patients with a larger hemothorax, particularly on the left side, showed prolonged resolution times. Regular imaging such as CXR or CT is recommended for up to 14 days post-intervention. After this period, outpatient follow-up is generally safe, although some patients may still have a persistent hemothorax beyond two weeks.
Core Tip: Traumatic hemothorax often requires chest tube insertion for resolution. However, the duration of follow-up for small or retained hemothorax (RH) remains uncertain. We aimed to determine the appropriate follow-up duration by using chest radiography (CXR) or computed tomography (CT). The study included 422 patients. Of these, 75% resolved their hemothorax within 7 days and 11% on days 8 to 14 post-admission. A subset of patients continued to experience RH despite early tube insertion. Patients with larger hemothoraces, particularly on the left side, exhibited prolonged resolution times. Regular imaging using CXR or CT is recommended for up to 14 days post-intervention.
