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| No. | Article Type | Article Title | Article Page |
|---|---|---|---|
| 1 | Review | Next-Generation Frozen Elephant Trunk Technique in the Era of Precision Medicine | 419 - 429 |
| 2 | Clinical Research | Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures: Valuable or a Waste of Resources? | 430 - 439 |
| 3 | Clinical Research | Potential Survival Benefit of Upfront Surgery for Lung Tumors Unconfirmed but Highly Suspicious for Stage I Lung Cancer | 440 - 446 |
| 4 | Commentary | Commentary: Preoperative versus Intraoperative Tissue Diagnosis in Highly Suspicious Stage I Lung Cancer: Which Is the Superior Approach? | 447 - 449 |
| 5 | Clinical Research | Comparative Study of Indocyanine Green Intravenous Injection and the Inflation-Deflation Method for Assessing Resection Margins in Segmentectomy for Lung Cancer: A Single-Center Retrospective Study | 450 - 457 |
| 6 | Commentary | Commentary: Comparative Study of Indocyanine Green Intravenous Injection and the Inflation-Deflation Method for Assessing Resection Margins in Segmentectomy for Lung Cancer: A Single-Center Retrospective Study | 458 - 459 |
| 7 | Clinical Research | Different DL<sub>CO</sub> Parameters as Predictors of Postoperative Pulmonary Complications in Mild Chronic Obstructive Pulmonary Disease Patients with Lung Cancer | 460 - 466 |
| 8 | Clinical Research | Prognostic Implications of Selective Dissection of Left Lower Paratracheal Lymph Nodes in Patients with Left-Sided Non-Small Cell Lung Cancer | 467 - 476 |
| 9 | Clinical Research | Interfissural Fixation of the Right Middle Lobe after Video-Assisted Thoracic Surgery Right Upper Lobectomy: Bronchial Anatomical Changes and Efficacy in Preventing Torsion | 477 - 483 |
| 10 | Clinical Research | Recurrence-Free Survival after Postoperative Hormone Therapy for Catamenial Pneumothorax | 484 - 489 |
| 11 | Commentary | Commentary: Thoracic Endometriosis: The Necessity of a Multidisciplinary Approach for Optimal Treatment | 490 - 491 |
| 12 | Case Report | Malignant Solitary Fibrous Tumor of the Mediastinum with Multiple Recurrences and a Rare Metastasis to the Thyroid Gland: A Case Report | 492 - 495 |
| 13 | Case Report | Mitral Valve Replacement for Bulky, Calcified Mitral Annulus: A Case Report | 496 - 499 |
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J Chest Surg
Published online September 27, 2024
Copyright © Journal of Chest Surgery.
Junepill Seok 
, M.D.1,2, Su Young Yoon , M.D.1, Jonghee Han , M.D.1, Yook Kim , M.D.3,4, Jong-Myeon Hong , M.D.1,2
1Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital; 2Department of Thoracic and Cardiovascular Surgery, Chungbuk National University College of Medicine; 3Department of Radiology, Chungbuk National University Hospital; 4Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence to:Jong-Myeon Hong
Tel 82-43-269-7350
Fax 82-43-269-7763
E-mail hongjm@chungbuk.ac.kr
ORCID
https://orcid.org/0000-0002-1659-8516
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Delayed hemothorax (dHTX) can occur unexpectedly, even in patients who initially present without signs of hemothorax (HTX), potentially leading to death. We aimed to develop a predictive model for dHTX requiring intervention, specifically targeting those with no or occult HTX.
Methods: This retrospective study was conducted at a level 1 trauma center. The primary outcome was the occurrence of dHTX requiring intervention in patients who had no HTX or occult HTX and did not undergo closed thoracostomy post-injury. To minimize overfitting, we employed the least absolute shrinkage and selection operator (LASSO) logistic regression model for feature selection. Thereafter, we developed a multivariable logistic regression (MLR) model and a nomogram.
Results: In total, 688 patients were included in the study, with 64 cases of dHTX (9.3%). The LASSO and MLR analyses revealed that the depth of HTX (adjusted odds ratio [aOR], 3.79; 95% confidence interval [CI], 2.10–6.85; p<0.001) and the number of totally displaced rib fractures (RFX) (aOR, 1.90; 95% CI, 1.56–2.32; p<0.001) were significant predictors. Based on these parameters, we developed a nomogram to predict dHTX, with a sensitivity of 78.1%, a specificity of 76.0%, a positive predictive value of 25.0%, and a negative predictive value of 97.1% at the optimal cut-off value. The area under the receiver operating characteristic curve was 0.832.
Conclusion: The depth of HTX on initial chest computed tomography and the number of totally displaced RFX emerged as significant risk factors for dHTX. We propose a novel nomogram that is easily applicable in clinical settings.
Keywords: Delayed hemothorax, Occult hemothorax, Rib fractures, Least absolute shrinkage and selection operator, Nomograms
J Chest Surg
Published online September 27, 2024
Copyright © Journal of Chest Surgery.
Junepill Seok , M.D.1,2, Su Young Yoon , M.D.1, Jonghee Han , M.D.1, Yook Kim , M.D.3,4, Jong-Myeon Hong , M.D.1,2
1Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital; 2Department of Thoracic and Cardiovascular Surgery, Chungbuk National University College of Medicine; 3Department of Radiology, Chungbuk National University Hospital; 4Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence to:Jong-Myeon Hong
Tel 82-43-269-7350
Fax 82-43-269-7763
E-mail hongjm@chungbuk.ac.kr
ORCID
https://orcid.org/0000-0002-1659-8516
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Delayed hemothorax (dHTX) can occur unexpectedly, even in patients who initially present without signs of hemothorax (HTX), potentially leading to death. We aimed to develop a predictive model for dHTX requiring intervention, specifically targeting those with no or occult HTX.
Methods: This retrospective study was conducted at a level 1 trauma center. The primary outcome was the occurrence of dHTX requiring intervention in patients who had no HTX or occult HTX and did not undergo closed thoracostomy post-injury. To minimize overfitting, we employed the least absolute shrinkage and selection operator (LASSO) logistic regression model for feature selection. Thereafter, we developed a multivariable logistic regression (MLR) model and a nomogram.
Results: In total, 688 patients were included in the study, with 64 cases of dHTX (9.3%). The LASSO and MLR analyses revealed that the depth of HTX (adjusted odds ratio [aOR], 3.79; 95% confidence interval [CI], 2.10–6.85; p<0.001) and the number of totally displaced rib fractures (RFX) (aOR, 1.90; 95% CI, 1.56–2.32; p<0.001) were significant predictors. Based on these parameters, we developed a nomogram to predict dHTX, with a sensitivity of 78.1%, a specificity of 76.0%, a positive predictive value of 25.0%, and a negative predictive value of 97.1% at the optimal cut-off value. The area under the receiver operating characteristic curve was 0.832.
Conclusion: The depth of HTX on initial chest computed tomography and the number of totally displaced RFX emerged as significant risk factors for dHTX. We propose a novel nomogram that is easily applicable in clinical settings.
Keywords: Delayed hemothorax, Occult hemothorax, Rib fractures, Least absolute shrinkage and selection operator, Nomograms
2024; 57(2): 120-125
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