Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Republic of Korea.
Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-Gu, Seoul 05278, Republic of Korea.
Am J Emerg Med. 2018 Dec;36(12):2249-2253. doi: 10.1016/j.ajem.2018.04.020. Epub 2018 Apr 14.
To investigate the impact of short-term exposure to air pollutants and meteorological variation on ED visits for primary spontaneous pneumothorax (PSP).
We retrospectively identified PSP cases that presented at the ED of our tertiary center between January 2015 and September 2016. We classified the days into three types: no PSP day (0 case/day), sporadic days (1-2 cases/day), and cluster days (PSP, ≥3 cases/day). Association between the daily incidence of PSP with air pollutants and meteorological data were determined using Poisson generalized-linear-model to calculate incidence rate ratio (IRRs) and the use of time-series (lag-1 [the cumulative air pollution level on the previous day of PSP], lag-2 [two days ago], and lag-3 [three days ago]).
Using multivariate logistic regression analysis, O (p = 0.010), NO (p = 0.047), particulate matters (PM) (p = 0.021), and PM (p = 0.008) were significant factors of PSP occurrence. When the concentration of O, NO, PM, and PM were increased, PSP IRRs increased approximately 15, 16, 3, and 5-fold, respectively. With the time-series analyses, atmospheric pressure in lag-3 was significantly lower and in lag-2, was significantly higher in PSP days compared with no PSP days. Among air pollutant concentrations, O in lag-1 (p = 0.017) and lag-2 (p = 0.038), NO in lag-1 (p = 0.015) and lag-2 (p = 0.009), PM in lag-1 (p = 0.012), and PM in lag-1 (p = 0.021) and lag-2 (p = 0.032) were significantly different between no PSP and PSP days.
Increased concentrations of air pollutants and abrupt change in atmospheric pressure were significantly associated with increased IRR of PSP.
探讨短期暴露于空气污染物和气象变化对原发性自发性气胸（PSP）急诊就诊的影响。
我们回顾性地确定了 2015 年 1 月至 2016 年 9 月期间在我们的三级中心急诊就诊的 PSP 病例。我们将这些天分为三类：无 PSP 天（0 例/天）、散在天（1-2 例/天）和聚类天（PSP，≥3 例/天）。使用泊松广义线性模型确定 PSP 每日发病率与空气污染物和气象数据之间的关联，以计算发病率比（IRR）和时间序列（PSP 前一天的累积空气污染水平[前一天]，前两天[前两天]和前两天[前两天]）。
使用多元逻辑回归分析，O（p=0.010），NO（p=0.047），颗粒物（PM）（p=0.021）和 PM（p=0.008）是 PSP 发生的重要因素。当 O，NO，PM 和 PM 的浓度增加时，PSP 的 IRR 分别增加了约 15、16、3 和 5 倍。在时间序列分析中，与无 PSP 日相比，PSP 日的大气压在滞后 3 日时显着降低，在滞后 2 日时显着升高。在空气污染物浓度中，O 在滞后 1 日（p=0.017）和滞后 2 日（p=0.038），NO 在滞后 1 日（p=0.015）和滞后 2 日（p=0.009），PM 在滞后 1 日（p=0.012），以及 PM 在滞后 1 日（p=0.021）和滞后 2 日（p=0.032）在无 PSP 日和 PSP 日之间差异有统计学意义。
空气污染物浓度的增加和大气压的突然变化与 PSP 的 IRR 增加显着相关。
