Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease

Abstract Background Evaluation of the diagnostic value of routine chest tube tip culture for detection of postoperative infection after surgery for noninfectious lung disease. Methods Included subjects were patients who underwent lung surgery between January 1st 2013 and January 1st 2018 in Universi...

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Autores principales:	Martijn van Schelt, Kevin Jenniskens, Rob J. Rentenaar, Inez Bronsveld
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Bacterial culture Chest tube Infection Lung surgery Perioperative care Diagnostic accuracy Surgery RD1-811 Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/e0481f9155f94a32a5af428ba527ab65
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spelling	oai:doaj.org-article:e0481f9155f94a32a5af428ba527ab652021-11-14T12:33:56ZDiagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease10.1186/s13019-021-01713-61749-8090https://doaj.org/article/e0481f9155f94a32a5af428ba527ab652021-11-01T00:00:00Zhttps://doi.org/10.1186/s13019-021-01713-6https://doaj.org/toc/1749-8090Abstract Background Evaluation of the diagnostic value of routine chest tube tip culture for detection of postoperative infection after surgery for noninfectious lung disease. Methods Included subjects were patients who underwent lung surgery between January 1st 2013 and January 1st 2018 in University Medical Centre Utrecht and of whom a chest tube tip was cultured. Postoperative outcomes included pneumonia, surgical site infection, and empyema within 30 days after surgery. Univariable analysis for diagnostic accuracy of chest tube tip culture results predicting these postoperative outcomes was performed, as well as multivariable analysis using penalized firth logistic regression. Results Patients developed one or more postoperative infections in 42 out of 210 (20%) lung surgeries. Pneumonia, surgical site infection, and empyema were found in 36 (17%), 8 (4%), and 2 (1%) cases respectively. Chest tube tip culture had a sensitivity of 31%, a specificity of 83%, a positive predictive value of 32%, and a negative predictive value of 83% for postoperative infections. In the subgroup of patients who did not have evidence of postoperative infection at the time of chest tube removal, the drain tip culture’s positive and negative predictive value changed to 18% and 92% respectively. Adding additional variables to chest tube tip culture in a prediction model resulting in only limited improvement in diagnostic performance. Conclusions We found insufficient diagnostic performance to support the practice of routine chest tube tip culture after surgery for noninfectious lung disease. Therefore, routine chest tube tip culture is not advisable and should be omitted to unburden the healthcare process and prevent low value care together with extra costs.Martijn van ScheltKevin JenniskensRob J. RentenaarInez BronsveldBMCarticleBacterial cultureChest tubeInfectionLung surgeryPerioperative careDiagnostic accuracySurgeryRD1-811AnesthesiologyRD78.3-87.3ENJournal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Bacterial culture Chest tube Infection Lung surgery Perioperative care Diagnostic accuracy Surgery RD1-811 Anesthesiology RD78.3-87.3
spellingShingle	Bacterial culture Chest tube Infection Lung surgery Perioperative care Diagnostic accuracy Surgery RD1-811 Anesthesiology RD78.3-87.3 Martijn van Schelt Kevin Jenniskens Rob J. Rentenaar Inez Bronsveld Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
description	Abstract Background Evaluation of the diagnostic value of routine chest tube tip culture for detection of postoperative infection after surgery for noninfectious lung disease. Methods Included subjects were patients who underwent lung surgery between January 1st 2013 and January 1st 2018 in University Medical Centre Utrecht and of whom a chest tube tip was cultured. Postoperative outcomes included pneumonia, surgical site infection, and empyema within 30 days after surgery. Univariable analysis for diagnostic accuracy of chest tube tip culture results predicting these postoperative outcomes was performed, as well as multivariable analysis using penalized firth logistic regression. Results Patients developed one or more postoperative infections in 42 out of 210 (20%) lung surgeries. Pneumonia, surgical site infection, and empyema were found in 36 (17%), 8 (4%), and 2 (1%) cases respectively. Chest tube tip culture had a sensitivity of 31%, a specificity of 83%, a positive predictive value of 32%, and a negative predictive value of 83% for postoperative infections. In the subgroup of patients who did not have evidence of postoperative infection at the time of chest tube removal, the drain tip culture’s positive and negative predictive value changed to 18% and 92% respectively. Adding additional variables to chest tube tip culture in a prediction model resulting in only limited improvement in diagnostic performance. Conclusions We found insufficient diagnostic performance to support the practice of routine chest tube tip culture after surgery for noninfectious lung disease. Therefore, routine chest tube tip culture is not advisable and should be omitted to unburden the healthcare process and prevent low value care together with extra costs.
format	article
author	Martijn van Schelt Kevin Jenniskens Rob J. Rentenaar Inez Bronsveld
author_facet	Martijn van Schelt Kevin Jenniskens Rob J. Rentenaar Inez Bronsveld
author_sort	Martijn van Schelt
title	Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
title_short	Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
title_full	Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
title_fullStr	Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
title_full_unstemmed	Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
title_sort	diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e0481f9155f94a32a5af428ba527ab65
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Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease

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