Abstract
Objective
The objective was to evaluate if existence of hydrothorax in initial chest radiograph
predicts treatment outcome in patients with primary spontaneous pneumothorax who received
needle thoracostomy.
Methods
This is a retrospective cohort study carried out from January 2011 to August 2014
in 1 public hospital in Hong Kong. All consecutive adult patients aged 18 years or above who attended the emergency department with the diagnosis of primary
spontaneous pneumothorax with needle aspiration performed as primary treatment were
included. Age, smoking status, size of pneumothorax, previous history of pneumothorax,
aspirated gas volume and presence of hydropneumothorax in initial radiograph were
included in the analysis. The outcome was success or failure of the needle aspiration.
Logistic regression was used to identify the predicting factors of failure of needle
aspiration.
Result
There were a total of 127 patients included. Seventy-three patients (57.5%) were successfully
treated with no recurrence upon discharge. Among 54 failure cases, 13 patients (10.2%)
failed immediately after procedure as evident by chest radiograph and required second
treatment. Forty-one patients (32.3%) failed upon subsequent chest radiographs. Multivariate
logistic regression showed factors independently associated with the failure of needle
aspiration, which included hydropneumothorax in the initial radiograph (odds ratio
[OR] = 4.47 [1.56i12.83], P = .005), previous history of pneumothorax (OR = 3.92 [1.57-9.79], P = .003), and large size of pneumothorax defined as apex-to-cupola distance ≥5 cm (OR = 2.75 [1.21-6.26], P = .016).
Conclusions
Hydropneumothorax, previous history of pneumothorax, and large size were independent
predictors of failure of needle aspiration in treatment of primary spontaneous pneumothorax.
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Article Info
Publication History
Published online: March 11, 2016
Accepted:
March 8,
2016
Received in revised form:
March 8,
2016
Received:
December 30,
2015
Footnotes
☆All authors did not have any personal or financial support or author involvement with organization(s) with financial interest in the subject matter, or any conflict of interest.
☆☆The study was conducted in Department of Accident and Emergency Medicine, Tuen Mun Hospital, HKSAR.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
