Clinical Characteristics and Indicators of Spontaneous Hemopneumothorax Comparing With Primary Spontaneous
Mikito Suzuki1,2, Kaoru Kaseda1, Kaito Yano1
1Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, JPN.
Introduction:
This study aimed to investigate the clinical characteristics and indicators of spontaneous hemopneumothorax (SHP) compared with primary spontaneous pneumothorax (PSP).
Methods:
We retrospectively evaluated patients who underwent surgery for spontaneous pneumothorax (SP) between April 2003 and April 2019. Clinical characteristics and perioperative outcomes were compared between SHP and PSP.
Results:
We identified 17 (8%) and 194 (92%) patients who underwent surgery for SHP and PSP, respectively. The SHP group was significantly older (mean±standard deviation: 31±10 vs. 25±8 years; p=0.002), with a higher proportion of patients aged >30 years compared to the PSP group (53% vs. 21%; p=0.006). Furthermore, the SHP group had definitive characteristics, left-side pneumothorax (82% vs. 54%; p=0.022), smoking habits (59% vs. 29%; p=0.009), and fewer patients with episodes of ipsilateral SP (12% vs. 50%; p=0.002) than the PSP group. In SHP, the most frequent bleeding point was the superior thoracic aperture in 15 patients (88%), followed by the left mediastinum in one patient. Seven patients (41%) of the SHP group had hemodynamic instabilities and needed perioperative blood transfusion.
Conclusion:
SHP had distinct clinical characteristics compared to PSP. Older age (>30 years), left-side laterality, smoking status, and a first episode of pneumothorax were feasible indicators of SHP.
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