Pneumothorax in patients with COVID-19 pneumonia in the intensive care unit: an indicator of poor prognosis

Onur Küçük; Fatih Seğmen; Semih Aydemir

Makale detayları

Pneumothorax in patients with COVID-19 pneumonia in the intensive care unit: an indicator of poor prognosis

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.13-19

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341147

pISSN:

2717-7505

Anahtar kelimeler:

Özet:

 Aims: The objective of this study was to investigate whether the incidence and development of pneumothorax in patients hospitalized in the intensive care unit ICU with coronavirus disease 2019 COVID-19 pneumonia is associated with patient prognosis. Methods: This retrospective, cohort, descriptive study was initiated following approval from the ethics committee. The study was conducted on patients with confirmed COVID-19 pneumonia admitted to the tertiary ICU between March 2020 and March 2022. Data were collected from the patient registry system and ICU files. The patients were divided into two groups: those who developed pneumothorax and those who did not. The factors associated with mortality in the ICU were evaluated by univariate analysis and multiple logistic regression analysis. Results: The study included a total of 397 patients with confirmed cases of COVID-19 infection and pneumonia who were admitted to the ICU between March 2020 and March 2022. The mean age of the patients was 6215 years. Of the patients, 56.1 were male. Pneumothorax was identified in 6.8 of patients. In addition to pneumothorax, six patients 1.5 exhibited pneumomediastinum. The mortality rate was observed to be 40.5 among the total patient population. The mortality rate was 81.5 in the group with pneumothorax and 37.6 in the group without pneumothorax. The median time to mortality was 6 days range 129 days following the diagnosis of pneumothorax. Pneumothorax alone increased the likelihood of mortality in the ICU sevenfold OR 7.3, 95 CI2.7019.75 and twofold when other variables were taken into account OR 2, 95 CI0.57-6.99. Conclusion: Pneumothorax is a common and fatal complication affecting mortality in patients with COVID-19 pneumonia in the ICU, despite the use of protective ventilation strategies. Particular caution should be exercised in patients receiving respiratory support in the ICU and in patients with a severe inflammatory response.

 Aims: The objective of this study was to investigate whether the incidence and development of pneumothorax in patients hospitalized in the intensive care unit ICU with coronavirus disease 2019 COVID-19 pneumonia is associated with patient prognosis. Methods: This retrospective, cohort, descriptive study was initiated following approval from the ethics committee. The study was conducted on patients with confirmed COVID-19 pneumonia admitted to the tertiary ICU between March 2020 and March 2022. Data were collected from the patient registry system and ICU files. The patients were divided into two groups: those who developed pneumothorax and those who did not. The factors associated with mortality in the ICU were evaluated by univariate analysis and multiple logistic regression analysis. Results: The study included a total of 397 patients with confirmed cases of COVID-19 infection and pneumonia who were admitted to the ICU between March 2020 and March 2022. The mean age of the patients was 6215 years. Of the patients, 56.1 were male. Pneumothorax was identified in 6.8 of patients. In addition to pneumothorax, six patients 1.5 exhibited pneumomediastinum. The mortality rate was observed to be 40.5 among the total patient population. The mortality rate was 81.5 in the group with pneumothorax and 37.6 in the group without pneumothorax. The median time to mortality was 6 days range 129 days following the diagnosis of pneumothorax. Pneumothorax alone increased the likelihood of mortality in the ICU sevenfold OR 7.3, 95 CI2.7019.75 and twofold when other variables were taken into account OR 2, 95 CI0.57-6.99. Conclusion: Pneumothorax is a common and fatal complication affecting mortality in patients with COVID-19 pneumonia in the ICU, despite the use of protective ventilation strategies. Particular caution should be exercised in patients receiving respiratory support in the ICU and in patients with a severe inflammatory response.

 Aims: The objective of this study was to investigate whether the incidence and development of pneumothorax in patients hospitalized in the intensive care unit ICU with coronavirus disease 2019 COVID-19 pneumonia is associated with patient prognosis. Methods: This retrospective, cohort, descriptive study was initiated following approval from the ethics committee. The study was conducted on patients with confirmed COVID-19 pneumonia admitted to the tertiary ICU between March 2020 and March 2022. Data were collected from the patient registry system and ICU files. The patients were divided into two groups: those who developed pneumothorax and those who did not. The factors associated with mortality in the ICU were evaluated by univariate analysis and multiple logistic regression analysis. Results: The study included a total of 397 patients with confirmed cases of COVID-19 infection and pneumonia who were admitted to the ICU between March 2020 and March 2022. The mean age of the patients was 6215 years. Of the patients, 56.1 were male. Pneumothorax was identified in 6.8 of patients. In addition to pneumothorax, six patients 1.5 exhibited pneumomediastinum. The mortality rate was observed to be 40.5 among the total patient population. The mortality rate was 81.5 in the group with pneumothorax and 37.6 in the group without pneumothorax. The median time to mortality was 6 days range 129 days following the diagnosis of pneumothorax. Pneumothorax alone increased the likelihood of mortality in the ICU sevenfold OR 7.3, 95 CI2.7019.75 and twofold when other variables were taken into account OR 2, 95 CI0.57-6.99. Conclusion: Pneumothorax is a common and fatal complication affecting mortality in patients with COVID-19 pneumonia in the ICU, despite the use of protective ventilation strategies. Particular caution should be exercised in patients receiving respiratory support in the ICU and in patients with a severe inflammatory response.

 Amaç: Bu çalışmanın amacı, koronavirüs hastalığı 2019 COVID-19 pnömonisi nedeniyle yoğun bakım ünitesinde YBÜ yatan hastalarda pnömotoraks insidansı ve gelişiminin hasta prognozu ile ilişkili olup olmadığını araştırmaktır. Yöntemler: Bu retrospektif, kohort, tanımlayıcı çalışma etik kurul onayının ardından başlatıldı. Çalışma, Mart 2020 ile Mart 2022 arasında üçüncü basamak YBÜye yatırılan doğrulanmış COVID-19 pnömonisi olan hastalar üzerinde yürütüldü. Veriler hasta kayıt sisteminden ve YBÜ dosyalarından toplandı. Hastalar pnömotoraks gelişenler ve gelişmeyenler olmak üzere iki gruba ayrıldı. YBÜdeki mortalite ile ilişkili faktörler tek değişkenli analiz ve çoklu lojistik regresyon analizi ile değerlendirildi. Bulgular: Çalışmaya Mart 2020 ile Mart 2022 arasında YBÜye yatırılan doğrulanmış COVID-19 enfeksiyonu ve pnömonisi olan toplam 397 hasta dahil edildi. Hastaların yaş ortalaması 62  15 yıl idi. Hastaların 56,1i erkekti. Hastaların 6,8inde pnömotoraks tespit edildi. Pnömotoraksa ek olarak altı hastada 1,5 pnömomediastinum görüldü. Toplam hasta popülasyonunda mortalite oranı 40,5 idi. Pnömotorakslı grupta mortalite oranı 81,5, pnömotorakssız grupta ise 37,6 olarak bulundu. Pnömotoraks tanısından sonra mortaliteye kadar geçen medyan süre 6 gündü aralığı 1-29 gün. Pnömotoraks tek başına YBÜde mortaliteyi yedi kat, diğer değişkenler hesaba katıldığında ise iki kat arttırdı. Sonuç: Pnömotoraks, koruyucu ventilasyon stratejilerinin kullanılmasına rağmen YBÜde COVID-19 pnömonisi olan hastalarda mortaliteyi etkileyen yaygın ve ölümcül bir komplikasyondur. YBÜde solunum desteği alan hastalarda ve şiddetli inflamatuar yanıtı olan hastalarda özellikle dikkat edilmelidir.

Makale detayları

Pneumothorax in patients with COVID-19 pneumonia in the intensive care unit: an indicator of poor prognosis

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.13-19

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341147

pISSN:

2717-7505

Pneumothorax

pneumomediastinum

intensive care unit

prognosis

COVID-19pnömotoraks

pnömomediastinum

yoğun bakım ünitesi

prognoz

COVID-19

Sayı

Makale detayları

Yazarlar: Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Yoğun Bakım

Dergi: Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.13-19

Belge Tipi: Makale

Yayın Tarihi: 2/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001341147

pISSN: 2717-7505

Sayı

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.13-19

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341147

pISSN:

2717-7505