Chest Drain Fall-Out Rate According to Suturing Practices: A Retrospective Direct Comparison.

BACKGROUND: Chest drains often become displaced and require replacement, adding unnecessary risks to patients. Simple measures such as suturing of the drain may reduce fall-out rates; however, there is no direct data to demonstrate this and no standardized recommended practice that is evidence based. OBJECTIVES: The study aimed to analyze the rate of chest drain fall out according to suturing practice. METHODS: Retrospective analysis of all chest drain insertions (radiology and pleural teams) in 2015-2016. Details of chest drain fall out were collected from patient electronic records. Drain "fall out" was pre-hoc defined as the drain tip becoming dislodged outside the pleural cavity unintentionally before a clinical decision was taken to remove the drain. RESULTS: A total of 369 chest drains were inserted: sutured (n = 106, 28.7%; 44 male [41.5%], median age 74 [interquartile range (IQR) 21] years), and unsutured (n = 263, 71.3%; 139 male [52.9%], median age 68 [IQR 21] years). Of the sutured drains, 7 (6.6%) fell out after a mean of 3.3 days (SD 2.6) compared to 39 (14.8%; p = 0.04) unsutured drains falling out after a mean of 2.7 days (SD 2.0; p = 0.8). CONCLUSIONS: Within the limits of this retrospective analysis, these results -suggest that suturing of drains is associated with lower fall-out rates.