SESSION TITLE: Cardiac and Thoracic Surgery Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: The ability to accurately characterize a pulmonary air leak (PAL) is an essential skill for those caring for thoracic surgery patients. The objective was to evaluate inter-observer reliability in PAL assessments using analog (Pleurevac®, Teleflex) and digital (Thopaz®, Medela) pleural drainage systems.
METHODS: Lung resection patients with a PAL were prospectively evaluated by at least 1 thoracic surgeon, 1 surgical resident, and 1-2 nurses using a standardized questionnaire. Each patient was assessed at the bedside first with the analog system and then the digital system. The thoracic surgeon evaluation was considered the reference standard for comparison. Analog Air leak severity was classified using the Robert David Cerfolio (RDC) system. Kappa (k) statistics were used to quantify agreement between observers.
RESULTS: A total of 128 PAL evaluations were completed in 30 patients (thoracic surgeon=30; nurse=56; resident=30; physiotherapists=12). Mean (SD) time between analog and digital assessment was 2.16 (1.66) hours. For PAL severity, the overall level of observer agreement using the analog system was slight k=0.03 (CI: -0.04, 0.11); p=0.40. Agreement overall using the digital system was substantial k=0.61 (CI: 0.49, 0.73); p < 0.01. Across all subcategories of allied health professionals, a consistent increased level of agreement in air leak severity assessment using the digital chest drainage was observed.
CONCLUSIONS: With the analog drainage systems, there was poor inter-observer reliability in quantifying PAL severity. Digital pleural drainage technology improves consistency between thoracic surgeons and other members of the allied health care team in bedside evaluation of PAL.
CLINICAL IMPLICATIONS: Digital pleural drainage technology improves consistency between thoracic surgeons and other members of the allied health care team in bedside evaluation of PAL.
DISCLOSURE: The following authors have nothing to disclose: Anna McGuire, Sebastien Gilbert, William Petrcich, Tim Ramsay, Andrew Seely, Donna Maziak, Sudhir Sundaresan, Farid Shamji
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