Use of an evidence-based algorithm for patients with traumatic hemothorax reduces need for additional interventions.

Background: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. Methods: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013. An evidence-based management algorithm was initiated for the management of retained hemothoraces. Patients with LOS 1 intervention. Secondary outcomes were empyema rate, number of patients requiring specific additional interventions, 28-day ventilator-free days, 28-day ICU-free days, hospital LOS, all-cause six-month readmission rate. Standard statistical analysis was performed for all data. Results: 642 patients (326 pre and 316 post) met study criteria. There were no demographic differences in either group. The number of patients requiring >1 intervention was significantly reduced (49 pre vs 28 post, p=0.02). Number of patients requiring VATS decreased (27 pre vs 10 post, p

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