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BMI was calculated using a standard formula (BMI?=?[mass (lbs)?��?703]/[height (in) [2]]), and the chest wall thickness at the second ICS in the mid-clavicular line was measured. As previously described by Zengerink, the coronal scout film was reviewed and the mid-clavicular line identified. The coronal scout film and the axial images were viewed side-by-side, and a cross reference line was used to identify the second ICS in the mid-clavicular line on the scout film and the axial Images [8]. Patients were then grouped by BMI as underweight (��18.5?kg/m2), normal weight [http://www.selleckchem.com/products/otx015.html OTX015 chemical structure] (18.6�C24.9?kg/m2), overweight (25�C29.9?kg/m2), or obese (��30?kg/m2). Failure rates were calculated based on patients having a measured distance from skin to pleura?>?5?cm in the second ICS as described by Sanchez et al. [12]. Data were reported in counts, frequencies, means, standard deviations, medians, and interquartile range. Categorical data were analysed with the X2 Test of Independence, while numerical variables used the ANOVA, with post hoc analysis done with Fisher's Least Squares Difference or Kruskal Wallis for severely non-normal data. To determine [http://www.selleckchem.com/products/AG-014699.html Rucaparib purchase] the relationship between BMI and intercostal space, Pearson's correlation was used. All analyses were performed in SAS? 9.1 (SAS Institute, Cary NC), and p-values less than 0.05 were considered significant. There were CT scans available for 326 patients during the study period. Patients were predominately male (69.9%, Table 1), with a mean age of 42.6 [SD 19.2] years. Almost all had experienced blunt trauma (93.9%). Most [https://en.wikipedia.org/wiki/ALPI ALPI] patients had been in a motor vehicle collision (62.6%), which rose higher if ATV and motorcycle incidents were included (71.2%). Patients had a mean Injury Severity Score (ISS) of 17.8 [SD 11.0] (Table 1). On admittance to the Emergency Department, patients had a mean Revised Trauma Score (RTS) of 10.3 [SD 3.1] and Glasgow Coma Score (GCS) of 12.1 [SD 4.9]. The average right 2nd intercostal space (ICS) was measured at 6.2 [SD 1.9]?cm, and the left was measured at 6.3 [SD 1.9]?cm. Only one patient received a needle thoracostomy in the field (0.3%, Table 1). On average, patients spent 12.6 [SD 18.1] days in the hospital, with 5.1 [SD 7.7] days in the ICU, and 4.7 [SD 9.7] days on a ventilator. Patient age differed significantly between BMI groups (Table 2), with patients considered at normal weight being significant younger (p?=?0.009) than those considered overweight or obese. Additionally, patients who were underweight were significantly more likely to be female (p?=?0.01). However, patients�� ISS, GCS, RTS, hospital length of stay, ICU length of stay, and ventilator days were not significantly different between BMI groups. There was a significant correlation between BMI and the depth of both the left (correlation coefficient?=?0.64, p?