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Simple X-ray Metric Predicts Postoperative Course After Spontaneous Pneumothorax Surgery
Eyüp Halit Yardimci1, Nur Simge Kokles2
1Thoracic Surgery, Marmara University, Istanbul, TUR.
Background:
Predicting postoperative outcomes in patients with spontaneous pneumothorax (SP) remains clinically valuable. This study investigates whether a radiological thoracic (RT) index, calculated as the chest height-to-width ratio on posteroanterior (PA) chest radiographs (CXR), can serve as a predictor after SP surgery.
Methods:
In this retrospective study, 195 patients who underwent surgery for SP were included. Patients were grouped according to surgery reasons as recurrence (n=101), preoperative persistent air leak (PAL) (n=58), and bilateral pneumothorax history (n=36). The RT index was calculated on PA CXRs using the involved side (right side for bilateral cases). Comparisons were made between patient groups, and linear regression was used to determine independent predictors of the RT index.
Results:
The mean RT index was 2.41±0.33. The RT index was significantly higher in patients with chest tube duration ≥5 days (2.49±0.34 vs. 2.34±0.31, p<0.001). Age was negatively correlated with the RT index (r=-0.459, p<0.001), while chest tube duration after surgery positively correlated (r=0.170, p=0.017). Multivariate regression identified age and postoperative PAL as independent predictors of the RT index (p<0.001). No significant difference in the RT index was found among recurrence, preoperative PAL, or bilateral pneumothorax history groups.
Conclusion:
The RT index derived from routine CXRs may help predict prolonged chest tube duration in patients undergoing surgery for SP. This simple radiological metric could contribute to perioperative risk stratification.
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