Farag Gamal Abdelshafy Ibrahim, Zineldin Mokhles Abdelfadil Ibrahim, Al Awady Ramadan Shawky Abd Alaziz, Abd El Salam Ahmed Bedeir, Elkahely Mohamed Attia
Cardiothoracic Surgery Department, Damietta Faculty of Medicine, Al-Azhar University, Damietta, EGY.
Chest Diseases Department, Damietta Faculty of Medicine, Al-Azhar University, Damietta, EGY.
Cureus. 2024 Jul 23;16(7):e65216. doi: 10.7759/cureus.65216. eCollection 2024 Jul.
This study aimed to explore the differences between primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax (SSP) in demographic and clinical features, management trends, and outcomes, alongside assessing recurrence risk factors in spontaneous pneumothorax (SP) patients.
This retrospective cohort study at New Damietta Hospital, Al-Azhar University, examined data from adults diagnosed with SP, differentiating between PSP and SSP types based on clinical and radiological criteria, to analyze demographics, clinical characteristics, management strategies, and outcomes.
In a study of 170 patients, 42.94% were diagnosed with PSP and 57.06% with SSP, showing significant differences in age distribution (P=0.042) and smoking habits (P<0.001 for both tobacco and cannabis). Management approaches varied, with conservative methods more common in PSP (15.07%) and surgical interventions following intercostal tube (ICT) drainage significantly higher in SSP (40.21%, P=0.001). Length of hospital stay (LOS) and recurrence rates were significantly higher in SSP than PSP (P<0.001 for LOS; P=0.001 for recurrence), with postoperative complications and in-hospital mortality occurring exclusively in SSP (P=0.054 for complications, P<0.001 for mortality). Risk factors for recurrence included older age, presence of blebs/bullae (P<0.001), and lower hemoglobin and hematocrit levels (P=0.009 and P=0.008, respectively), with thoracic drainage duration longer in recurrent cases (P=0.008). Smoking status significantly impacted recurrence risk, with current smokers showing a higher risk compared to never-smokers (P=0.012).
This study highlights significant demographic, clinical, and management differences between primary and secondary spontaneous pneumothorax, underscoring the importance of tailored treatment strategies to improve patient outcomes. Key findings include the impact of smoking status on recurrence risk and the necessity for individualized management plans, especially in SSP patients who exhibit higher rates of recurrence, longer hospital stays, and greater morbidity.
本研究旨在探讨原发性自发性气胸（PSP）和继发性自发性气胸（SSP）在人口统计学和临床特征、治疗趋势及预后方面的差异，同时评估自发性气胸（SP）患者的复发风险因素。
这项在爱资哈尔大学新达米埃塔医院开展的回顾性队列研究，对诊断为SP的成年患者数据进行了检查，根据临床和放射学标准区分PSP和SSP类型，以分析人口统计学、临床特征、治疗策略及预后。
在一项对170例患者的研究中，42.94%被诊断为PSP，57.06%被诊断为SSP，在年龄分布（P = 0.042）和吸烟习惯（烟草和大麻的P均<0.001）方面存在显著差异。治疗方法各不相同，保守方法在PSP中更常见（15.07%），而在SSP中，肋间导管（ICT）引流后进行手术干预的比例显著更高（40.21%，P = 0.001）。SSP的住院时间（LOS）和复发率显著高于PSP（LOS的P<0.001；复发的P = 0.001），术后并发症和院内死亡率仅发生在SSP中（并发症的P = 0.054，死亡率的P<0.001）。复发的风险因素包括年龄较大、存在肺大疱（P<0.001）以及血红蛋白和血细胞比容水平较低（分别为P = 0.009和P = 0.008），复发病例的胸腔引流持续时间更长（P = 0.008）。吸烟状况对复发风险有显著影响，当前吸烟者的风险高于从不吸烟者（P = 0.012）。
本研究突出了原发性和继发性自发性气胸在人口统计学、临床及治疗方面的显著差异，强调了制定个性化治疗策略以改善患者预后的重要性。主要发现包括吸烟状况对复发风险的影响以及制定个性化管理计划的必要性，特别是在复发率更高、住院时间更长且发病率更高的SSP患者中。
