Buz Mesut, Özsaray Yunus Emre, Sesigüzel Mehmet İlhan, Doğruyol Mahmut Talha, Çimenoğlu Rıza Berk, Özdemir Attila, Demirhan Recep
Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Oct 21;32(4):436-444. doi: 10.5606/tgkdc.dergisi.2024.26856. eCollection 2024 Oct.
In this study, we aimed to evaluate the predictive value of the Haller index for recurrence risk in primary spontaneous pneumothorax patients.
Between January 2018 and December 2023, a total of 285 patients (260 males, 25 females; median age: 23 years; range, 17 to 35 years) with primary spontaneous pneumothorax who underwent thoracic computed tomography and followed for at least one year were retrospectively analyzed. The patients were divided into two groups as the non-recurrence group (n=170) and recurrence (n=115) group. The Haller index was calculated from computed tomography scans at presentation and its predictive value for recurrent pneumothorax was estimated.
The median age was significantly higher in the non-recurrence group than in the recurrence group (p <0.001). The median time to recurrence was two (IQR 1-3) months. The diagnostic validity of Haller index for predicting recurrence showed an area under the receiver operating characteristic of 0.824 (95% confidence interval [CI]: 0.775-0.866) (p <0.001). The optimal cut-off value of Haller index (>2.4) showed a sensitivity of 70.43% (95% CI: 61.2-78.6) and specificity of 76.47% (95% CI: 69.4-82.6).
A high Haller index is associated with increased recurrent pneumothorax risk in primary spontaneous pneumothorax patients. Traditionally used for pectus excavatum severity, incorporating Haller index in the management of these patients may help to identify high-risk patients and guide personalized management strategies.
在本研究中，我们旨在评估哈勒指数对原发性自发性气胸患者复发风险的预测价值。
回顾性分析2018年1月至2023年12月期间共285例（260例男性，25例女性；中位年龄：23岁；范围17至35岁）接受胸部计算机断层扫描并随访至少一年的原发性自发性气胸患者。将患者分为非复发组（n = 170）和复发组（n = 115）。根据初次就诊时的计算机断层扫描计算哈勒指数，并评估其对复发性气胸的预测价值。
非复发组的中位年龄显著高于复发组（p <0.001）。复发的中位时间为2（四分位间距1 - 3）个月。哈勒指数预测复发的诊断有效性显示，受试者工作特征曲线下面积为0.824（95%置信区间[CI]：0.775 - 0.866）（p <0.001）。哈勒指数的最佳截断值（>2.4）显示敏感性为70.43%（95% CI：61.2 - 78.6），特异性为76.47%（95% CI：69.4 - 82.6）。
高哈勒指数与原发性自发性气胸患者复发性气胸风险增加相关。哈勒指数传统上用于评估漏斗胸严重程度，将其纳入这些患者的管理中可能有助于识别高危患者并指导个性化管理策略。
