Department of Surgery, University of Turku, Turku, Finland.
Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
Scand J Surg. 2024 Jun;113(2):160-165. doi: 10.1177/14574969241242316. Epub 2024 Apr 16.
There is a paucity of data on later healthcare visits and retreatments after primary treatment of spontaneous pneumothorax. The main purpose of this study was to describe retreatment rates up to 5 years after primary spontaneous pneumothorax treated with either surgery or tube thoracostomy (TT) at index hospitalization in Finland between 2005 and 2018 to estimate the burden of primary spontaneous pneumothorax on the healthcare system.
Retrospective registry-based study of patients with primary spontaneous pneumothorax treated with TT or surgery in Finland in 2005-2018. Rehospitalization and retreatment for recurrent pneumothorax and complications attributable to initial treatment were identified.
The total study population was 1594 patients. At 5 years, 53.2% (384/722) of TT treated and 33.8% (295/872) of surgically treated patients had undergone any retreatment. Surgery was associated with a lower risk of recurrence than TT (hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.43-0.56, p < 0.001). Male sex was associated with a lower risk of recurrent treatment (HR 0.75, 95% CI 0.63-0.90, p = 0.001). Higher age decreased the risk of recurrent treatment (HR 0.99, 95% CI 0.99-0.99, p < 0.001). At 5 years, 36.0% (260/722) of the TT treated and 18.8% (164/872) of the surgically treated had undergone reoperation at some point.
Reintervention rates and repeat hospital visits after TT and surgery were surprisingly high at long-term follow-up. Occurrences of retreatment and reoperation were significantly higher among primary spontaneous pneumothorax patients treated with TT at index hospitalization than among patients treated with surgery.
自发性气胸初次治疗后，关于后续医疗就诊和再次治疗的资料较为匮乏。本研究的主要目的是描述 2005 年至 2018 年期间，芬兰索引住院期间接受胸腔引流管（TT）或手术治疗的自发性气胸患者在 5 年内的再治疗率，以评估自发性气胸对医疗系统的负担。
这是一项回顾性基于登记的研究，纳入了芬兰 2005 年至 2018 年期间接受 TT 或手术治疗的自发性气胸患者。识别因复发性气胸和初始治疗相关并发症而再次住院和再次治疗的情况。
总研究人群为 1594 例患者。5 年后，TT 治疗组中 53.2%（384/722）和手术治疗组中 33.8%（295/872）的患者接受了任何形式的再次治疗。与 TT 相比，手术治疗与较低的复发风险相关（风险比[HR]0.50，95%置信区间[CI]0.43-0.56，p<0.001）。男性与较低的复发性治疗风险相关（HR 0.75，95%CI 0.63-0.90，p=0.001）。较高的年龄降低了复发性治疗的风险（HR 0.99，95%CI 0.99-0.99，p<0.001）。5 年后，TT 治疗组中 36.0%（260/722）和手术治疗组中 18.8%（164/872）的患者在某个时间点进行了再次手术。
在长期随访中，TT 和手术治疗后的再次干预率和再次住院就诊率非常高。与手术治疗相比，TT 治疗索引住院的自发性气胸患者的再治疗和再次手术发生率明显更高。
