Onuki Takuya, Ueda Sho, Yamaoka Masatoshi, Sekiya Yoshiaki, Yamada Hitoshi, Kawakami Naoki, Araki Yuichi, Wakai Yoko, Saito Kazuhito, Inagaki Masaharu, Matsumiya Naoki
Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
Can Respir J. 2017;2017:6014967. doi: 10.1155/2017/6014967. Epub 2017 Mar 13.
. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP). . We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis. . In the SSP group ( = 327; 34.9%), patient age, requirement for emergency transport, and length of stay were greater (all, < 0.001), while the prevalence of smoking ( = 0.023) and number of surgical interventions ( < 0.001) were lower compared to those in the PSP group ( = 611; 65.1%). Among the 16 in-hospital deceased patients, 12 (75.0%) received emergency transportation and 10 (62.5%) exhibited performance status (PS) of 3-4. In the SSP group, emergency transportation was an independent factor for in-hospital mortality (odds ratio 16.37; 95% confidence interval, 4.85-55.20; < 0.001). . The prevalence and clinical characteristics of PSP and SSP differ considerably. Patients with SSP receiving emergency transportation should receive careful attention.
自发性气胸(SP)的最佳治疗方法以及与院内死亡率相关的因素尚未完全明确。我们评估了日本原发性或继发性SP(PSP/SSP)患者的患病率、临床特征和院内死亡率。我们回顾性分析并将751例连续诊断为SP的患者的938例气胸病例分为PSP组和SSP组。通过多因素logistic回归分析确定与SSP院内死亡率相关的因素。在SSP组(n = 327;34.9%)中,患者年龄、急诊转运需求和住院时间更长(均P < 0.001),而与PSP组(n = 611;65.1%)相比,吸烟率(P = 0.023)和手术干预次数更低(P < 0.001)。在16例院内死亡患者中,12例(75.0%)接受了急诊转运,10例(62.5%)表现为3 - 4级的体能状态(PS)。在SSP组中,急诊转运是院内死亡的独立因素(比值比16.37;95%置信区间,4.85 - 55.20;P < 0.001)。PSP和SSP的患病率和临床特征有很大差异。接受急诊转运的SSP患者应予以密切关注。