Incidence, Management, and Outcomes of Patients With COVID-19 and Pneumothorax
Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Our objective was to report the incidence, management, and outcomes of patients who developed a secondary pneumothorax while admitted for coronavirus disease 2019 (COVID-19).
METHODS: A single-institution, retrospective review of patients admitted for COVID-19 with a diagnosis of pneumothorax between March 1, 2020, and April 30, 2020, was performed. The primary assessment was the incidence of pneumothorax. Secondarily, we analyzed clinical outcomes of patients requiring tube thoracostomy, including those requiring operative intervention.
RESULTS: From March 1, 2020, to April 30, 2020, 118 of 1595 patients (7.4%) admitted for COVID-19 developed a pneumothorax. Of these, 92 (5.8%) required tube thoracostomy drainage for a median of 12 days (interquartile range 5-25 days). The majority of patients (95 of 118, 80.5%) were on mechanical ventilation at the time of pneumothorax, 17 (14.4%) were iatrogenic, and 25 patients (21.2%) demonstrated tension physiology. Placement of a large-bore chest tube (20 F or greater) was associated with fewer tube-related complications than a small-bore tube (14 F or less) (14 vs 26 events, P = .011). Six patients with pneumothorax (5.1%) required operative management for a persistent alveolar-pleural fistula. In patients with pneumothorax, median hospital stay was 36 days (interquartile range 20-63 days) and in-hospital mortality was significantly higher than for those without pneumothorax (58% vs 13%, P < .001).
CONCLUSIONS: The incidence of secondary pneumothorax in patients admitted for COVID-19 is 7.4%, most commonly occurring in patients requiring mechanical ventilation, and is associated with an in-hospital mortality rate of 58%. Placement of large-bore chest tubes is associated with fewer complications than small-bore tubes.
| Errataetall: |
CommentIn: Ann Thorac Surg. 2022 Aug;114(2):407-408. - PMID 34487711 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:114 |
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| Enthalten in: |
The Annals of thoracic surgery - 114(2022), 2 vom: 15. Aug., Seite 401-407 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Geraci, Travis C [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.07.2022 Date Revised 01.08.2022 published: Print-Electronic CommentIn: Ann Thorac Surg. 2022 Aug;114(2):407-408. - PMID 34487711 Citation Status MEDLINE |
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| doi: |
10.1016/j.athoracsur.2021.07.097 |
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| funding: |
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| 500 | |a CommentIn: Ann Thorac Surg. 2022 Aug;114(2):407-408. - PMID 34487711 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Our objective was to report the incidence, management, and outcomes of patients who developed a secondary pneumothorax while admitted for coronavirus disease 2019 (COVID-19) | ||
| 520 | |a METHODS: A single-institution, retrospective review of patients admitted for COVID-19 with a diagnosis of pneumothorax between March 1, 2020, and April 30, 2020, was performed. The primary assessment was the incidence of pneumothorax. Secondarily, we analyzed clinical outcomes of patients requiring tube thoracostomy, including those requiring operative intervention | ||
| 520 | |a RESULTS: From March 1, 2020, to April 30, 2020, 118 of 1595 patients (7.4%) admitted for COVID-19 developed a pneumothorax. Of these, 92 (5.8%) required tube thoracostomy drainage for a median of 12 days (interquartile range 5-25 days). The majority of patients (95 of 118, 80.5%) were on mechanical ventilation at the time of pneumothorax, 17 (14.4%) were iatrogenic, and 25 patients (21.2%) demonstrated tension physiology. Placement of a large-bore chest tube (20 F or greater) was associated with fewer tube-related complications than a small-bore tube (14 F or less) (14 vs 26 events, P = .011). Six patients with pneumothorax (5.1%) required operative management for a persistent alveolar-pleural fistula. In patients with pneumothorax, median hospital stay was 36 days (interquartile range 20-63 days) and in-hospital mortality was significantly higher than for those without pneumothorax (58% vs 13%, P < .001) | ||
| 520 | |a CONCLUSIONS: The incidence of secondary pneumothorax in patients admitted for COVID-19 is 7.4%, most commonly occurring in patients requiring mechanical ventilation, and is associated with an in-hospital mortality rate of 58%. Placement of large-bore chest tubes is associated with fewer complications than small-bore tubes | ||
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| 700 | 1 | |a Cerfolio, Robert J |e verfasserin |4 aut | |
| 700 | 1 | |a Bizekis, Costas |e verfasserin |4 aut | |
| 700 | 1 | |a Zervos, Michael |e verfasserin |4 aut | |
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