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Tension pneumothorax, is it a really life-threatening condition?

Yoon JS, Choi SY, Suh JH, Jeong JY, Lee BY, Park YG, Kim CK, Park CB - J Cardiothorac Surg (2013)

Bottom Line: We reviewed patients who were admitted with spontaneous pneumothorax between August 1, 2003 and December 31, 2011.The bullae were large in patients with fibrotic adhesion than in those without adhesion (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm; P = 0.000).The size of the lung bullae and fibrotic adhesion contributes to the development of tension pneumothorax.

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Affiliation: Department of Thoracic and Cardiovascular Surgery, Incheon St, Mary's Hospital, The Catholic University of Korea, 665-8, Bupyeong-dong, Bupyeong-gu, Incheon 403-720, Republic of Korea. drcs5223@daum.net.

ABSTRACT

Background: Tension pneumothorax is a life-threatening occurrence that is infrequently the consequence of spontaneous pneumothorax. The aim of this study was to identify the risk factors for the development of tension pneumothorax and its effect on clinical outcomes.

Methods: We reviewed patients who were admitted with spontaneous pneumothorax between August 1, 2003 and December 31, 2011. Electronic medical records and the radiological findings were reviewed with chest x-ray and high-resolution computed tomography scans that were retrieved from the Picture Archiving Communication System.

Results: Out of the 370 patients included in this study, tension pneumothorax developed in 60 (16.2%). The bullae were larger in patients with tension pneumothorax than in those without (23.8 ± 16.2 mm vs 16.1 ± 19.1 mm; P = 0.007). In addition, the incidence of tension pneumothorax increased with the lung bulla size. Fibrotic adhesion was more prevalent in the tension pneumothorax group than in that without (P = 0.000). The bullae were large in patients with fibrotic adhesion than in those without adhesion (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm; P = 0.000). On multivariate analysis, the size of bullae (odds ratio (OR) = 1.03, P = 0.001) and fibrotic adhesion (OR = 10.76, P = 0.000) were risk factors of tension pneumothorax. Hospital mortality was 3.3% in the tension pneumothorax group and it was not significantly different from those patients without tension pneunothorax (P = 0.252).

Conclusions: Tension pneumothorax is not uncommon, but clinically fatal tension pneumothorax is extremely rare. The size of the lung bullae and fibrotic adhesion contributes to the development of tension pneumothorax.

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Comparison of bulla size relative to the presence of tension pneumothorax. Among patients without fibrotic adhesion, the bullae were larger in the tension pneumothorax group than in those without tension pneumothorax (15.2 ± 12.7 mm vs 9.8 ± 11.2 mm, P = 0.025). However, in cases where fibrotic adhesion was present, the size of the bullae did not differ significantly between the groups (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm; P = 0.323). ns, not statistically significant; * P 0.05.
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Figure 2: Comparison of bulla size relative to the presence of tension pneumothorax. Among patients without fibrotic adhesion, the bullae were larger in the tension pneumothorax group than in those without tension pneumothorax (15.2 ± 12.7 mm vs 9.8 ± 11.2 mm, P = 0.025). However, in cases where fibrotic adhesion was present, the size of the bullae did not differ significantly between the groups (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm; P = 0.323). ns, not statistically significant; * P 0.05.

Mentions: Fibrotic adhesion was more prevalent in the tension pneumothorax group than in the group without tension pneumothorax group (56.7% vs 27.3%, P < 0.001). The bullae were larger in patients with fibrotic adhesion than in those without (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm, P = <0.001). However, among those patients who exhibited adhesion, bulla size did not differ between patients with tension pneumothorax and those without (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm, P = 0.323) (Figure 2).


Tension pneumothorax, is it a really life-threatening condition?

Yoon JS, Choi SY, Suh JH, Jeong JY, Lee BY, Park YG, Kim CK, Park CB - J Cardiothorac Surg (2013)

Comparison of bulla size relative to the presence of tension pneumothorax. Among patients without fibrotic adhesion, the bullae were larger in the tension pneumothorax group than in those without tension pneumothorax (15.2 ± 12.7 mm vs 9.8 ± 11.2 mm, P = 0.025). However, in cases where fibrotic adhesion was present, the size of the bullae did not differ significantly between the groups (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm; P = 0.323). ns, not statistically significant; * P 0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016536&req=5

Figure 2: Comparison of bulla size relative to the presence of tension pneumothorax. Among patients without fibrotic adhesion, the bullae were larger in the tension pneumothorax group than in those without tension pneumothorax (15.2 ± 12.7 mm vs 9.8 ± 11.2 mm, P = 0.025). However, in cases where fibrotic adhesion was present, the size of the bullae did not differ significantly between the groups (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm; P = 0.323). ns, not statistically significant; * P 0.05.
Mentions: Fibrotic adhesion was more prevalent in the tension pneumothorax group than in the group without tension pneumothorax group (56.7% vs 27.3%, P < 0.001). The bullae were larger in patients with fibrotic adhesion than in those without (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm, P = <0.001). However, among those patients who exhibited adhesion, bulla size did not differ between patients with tension pneumothorax and those without (32.0 ± 15.1 mm vs 36.3 ± 24.8 mm, P = 0.323) (Figure 2).

Bottom Line: We reviewed patients who were admitted with spontaneous pneumothorax between August 1, 2003 and December 31, 2011.The bullae were large in patients with fibrotic adhesion than in those without adhesion (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm; P = 0.000).The size of the lung bullae and fibrotic adhesion contributes to the development of tension pneumothorax.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Incheon St, Mary's Hospital, The Catholic University of Korea, 665-8, Bupyeong-dong, Bupyeong-gu, Incheon 403-720, Republic of Korea. drcs5223@daum.net.

ABSTRACT

Background: Tension pneumothorax is a life-threatening occurrence that is infrequently the consequence of spontaneous pneumothorax. The aim of this study was to identify the risk factors for the development of tension pneumothorax and its effect on clinical outcomes.

Methods: We reviewed patients who were admitted with spontaneous pneumothorax between August 1, 2003 and December 31, 2011. Electronic medical records and the radiological findings were reviewed with chest x-ray and high-resolution computed tomography scans that were retrieved from the Picture Archiving Communication System.

Results: Out of the 370 patients included in this study, tension pneumothorax developed in 60 (16.2%). The bullae were larger in patients with tension pneumothorax than in those without (23.8 ± 16.2 mm vs 16.1 ± 19.1 mm; P = 0.007). In addition, the incidence of tension pneumothorax increased with the lung bulla size. Fibrotic adhesion was more prevalent in the tension pneumothorax group than in that without (P = 0.000). The bullae were large in patients with fibrotic adhesion than in those without adhesion (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm; P = 0.000). On multivariate analysis, the size of bullae (odds ratio (OR) = 1.03, P = 0.001) and fibrotic adhesion (OR = 10.76, P = 0.000) were risk factors of tension pneumothorax. Hospital mortality was 3.3% in the tension pneumothorax group and it was not significantly different from those patients without tension pneunothorax (P = 0.252).

Conclusions: Tension pneumothorax is not uncommon, but clinically fatal tension pneumothorax is extremely rare. The size of the lung bullae and fibrotic adhesion contributes to the development of tension pneumothorax.

Show MeSH
Related in: MedlinePlus