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Interpleural distance predicts persistent air leak after initial primary spontaneous pneumothorax
Takaki Akamine1, Takuro Kometani1, Asato Hashinokuchi1
1Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Journal of Thoracic Disease
|July 10, 2020
Summary
Persistent air leak (PAL) after initial drainage for primary spontaneous pneumothorax (PSP) is a risk factor for surgery. Larger pneumothorax size and early hospital admission predict PAL in first-episode PSP patients.
Area of Science:
- Thoracic surgery
- Pulmonology
- Medical diagnostics
Background:
- Surgical intervention for primary spontaneous pneumothorax (PSP) is debated.
- Persistent air leak (PAL) after initial drainage warrants surgical consideration.
- Identifying predictors of PAL is crucial for timely treatment decisions.
Purpose of the Study:
- To investigate risk factors for persistent air leak (PAL) in patients experiencing a first episode of primary spontaneous pneumothorax (PSP).
- To identify simple and effective predictors for PAL in PSP management.
Main Methods:
- Retrospective analysis of 122 patients with a first episode of PSP.
- PAL defined as air leak lasting ≥72 hours.
- Pneumothorax size assessed using interpleural distance, apex-cupola distance, and Light index on chest X-rays.
- Early hospital admission defined as admission within 24 hours of symptom onset.
Main Results:
- 55 patients (45%) developed PAL.
- Significantly larger pneumothorax size (all methods) in the PAL group (P<0.001).
- Early hospital admission was significantly associated with PAL (P=0.026).
- Interpleural distance at the hilum and early admission independently predicted PAL (P<0.001, P=0.008).
Conclusions:
- Interpleural distance at the hilum is a simple, effective predictor of PAL in first-episode PSP.
- Early hospital admission is also an independent predictor of PAL.
- Findings aid decision-making for initial surgical treatment in PSP.
Keywords:
Primary spontaneous pneumothorax (PSP)first episodepersistent air leak (PAL)pneumothorax sizevideo-assisted thoracoscopic surgery (VATS)More Related Videos
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