@article{Li2026, 
author = {Wenqing Li and Haoyu Jing and Huiping Zhang and Rui Bao and Zhen Yang and Yukun Luo and Mingbo Zhang},
title = {RiskFactors for Bleeding in Patients Undergoing Ultrasound-guided Tube Thoracostomy: A Retrospective Study of 4073 Patients},
year = {2026},
journal = {Advanced Ultrasound in Diagnosis and Therapy},
volume = {10},
number = {2},
pages = {98-105},
keywords = {Tube thoracostomy, Bleeding, Experience, Ultrasound, Malignancy},
url = {https://www.sciopen.com/article/10.26599/AUDT.2026.250068},
doi = {10.26599/AUDT.2026.250068},
abstract = {Background US-guided tube thoracostomy (US-TT) is widely employed for pleural effusion management, however bleeding complications remain a clinical concern.Objective To identify risk factors for bleeding during US-TT, focusing on doctor experience, coagulation status, malignancy, and anticoagulant/antiplatelet medication use.Methods In this retrospective cohort study, we analyzed 4,073 patients undergoing US-TT between January 2019 and January 2024. Using univariate analysis and multivariate binary logistic regression, we evaluated associations between post-procedural bleeding and the following factors: coagulation parameters (PLT, INR, APTT), inflammatory markers, use of anticoagulant/antiplatelet medications, malignancy status, and doctor experience (junior vs. senior). Demographic and clinical data were extracted from electronic medical records.Results Bleeding occurred in 24 patients (0.6%). Univariate analysis identified procedure performance by junior physicians and presence of malignancy as significant risk factors (P < 0.05). No significant associations were found with coagulation parameters, inflammatory markers, or medication use. Factors with P < 0.1 (junior doctor, malignancy, INR > 2.0, elevated leukocyte count) were included in multivariate analysis. This confirmed junior doctor status (OR, 3.333; P = 0.033) and malignancy (OR, 3.960; P = 0.016) as independent predictors of bleeding.Conclusions US-TT carries a low overall bleeding risk (0.6%). In this study, bleeding was associated with malignancy and less experienced doctors, but not significantly with routine coagulation indices. A trend toward increased risk with INR > 2.0 warrants caution.}
}