Department of Respiratory and Sleep Medicine, Wollongong Hospital, Sydney, New South Wales, Australia.
Faculty of Science, Medicine and Health, University of Wollongong, Sydney, New South Wales, Australia.
Intern Med J. 2024 Jan;54(1):172-177. doi: 10.1111/imj.16147. Epub 2023 Jun 16.
Pleural procedures are essential for the investigation and management of pleural disease and can be associated with significant morbidity and mortality. There is a lack of pleural procedure complication data in the Australian and New Zealand region.
To review pleural procedure practices at Wollongong Hospital with an emphasis on the assessment of complications, use of thoracic ultrasound (TUS), pathology results and comparison of findings with international data.
Retrospective analysis of medical records was performed on pleural procedures identified through respiratory specialist trainee logbooks at Wollongong Hospital from January 2018 to December 2021. Comparison of complication rates was made to the British Thoracic Society 2011 a national pleural audit.
One hundred and twenty-one pleural procedures were identified. There were 71 chest drains, 49 thoracocentesis and one indwelling pleural catheter (IPC) insertion. Ninety-seven per cent of procedures were performed for pleural effusions and 3% for pneumothorax. This audit demonstrated a complication rate (excluding pain) of 16.9% for chest drains and 4.1% for thoracocentesis. This gave an overall complication event rate of 10.8% (excluding pain) for pleural procedures. There was no major bleeding, organ puncture, pleural space infection or death. Bedside TUS was used in 99% of procedures.
Complication rates for pleural procedures performed by respiratory specialist trainees at Wollongong Hospital are comparable with international outcomes. This audit provides data for comparison on pleural procedure complication rates in Australia. Future studies are required to determine complication rates with IPCs.
胸膜操作对于胸膜疾病的检查和管理至关重要，但可能会引起严重的发病率和死亡率。澳大利亚和新西兰地区缺乏胸膜操作并发症的数据。
回顾卧龙岗医院的胸膜操作实践，重点评估并发症、胸腔超声（TUS）的使用、病理结果，并将发现与国际数据进行比较。
通过卧龙岗医院呼吸专科住院医师日志中确定的胸膜操作，对 2018 年 1 月至 2021 年 12 月的病历进行回顾性分析。将并发症发生率与英国胸科学会 2011 年全国胸膜审核进行比较。
共确定了 121 例胸膜操作。其中有 71 例胸腔引流管、49 例胸腔穿刺术和 1 例留置胸腔导管（IPC）插入术。97%的操作是为了处理胸腔积液，3%的操作是为了处理气胸。本研究显示胸腔引流管的并发症发生率（不包括疼痛）为 16.9%，胸腔穿刺术的并发症发生率为 4.1%。这使得胸膜操作的总体并发症发生率（不包括疼痛）为 10.8%。没有出现严重出血、器官穿孔、胸膜腔感染或死亡。99%的操作都进行了床旁 TUS。
卧龙岗医院呼吸专科住院医师进行的胸膜操作的并发症发生率与国际结果相当。本研究为澳大利亚胸膜操作并发症发生率提供了数据。需要进一步的研究来确定 IPC 的并发症发生率。
