How safe is it to discharge home patients with a chest tube in place? A narrative review of the literature

OBJECTIVES: In a time of particular focus on healthcare costs and quality metrics, combined with widespread embracing of the Early Recovery After Surgery approach, an outpatient setting for the management of prolonged air leak or excessive fluid drainage appears to be an acceptable option. The aim of this review is to evaluate the safety, efficacy and financial benefit of discharging home patients with chest tube after lung surgery or following chest drain insertion due to a pneumothorax. METHODS: We reviewed the current literature analysing all available full-text papers published in English (PubMed, Cochrane and EMBASE databases). Data were reported as descriptive narrative. RESULTS: Our findings show that discharging home patients with chest tube in situ has not only a positive impact on length of stay but it also seems to be cost-effective. In our literature review, contrasting results have emerged regarding readmission rates and development of complications, especially empyema. CONCLUSIONS: Thus, outpatients management of patients discharged with a chest drain is feasible and cost-effective. A standardization of follow-up with dedicated ambulatory setting might improve patients' safety and increase this practice amongst thoracic surgery institutions.