Analysis of pneumothorax cases admitted to the emergency department

INTRODUCTİON AND OBJECTİVES: Pneumothorax is a clinical definition that occurs when free air enters the potential space between the visceral and parietal lung pleura. It is the most common thoracic surgery emergency in emergency departments. Pneumothorax patients most often present to the emergency department with shortness of breath and chest pain. Pneumothoraces are clinically divided into two: acquired and spontaneous. It was aimed to conduct a study that would assist emergency medicine physicians in the process from diagnosis to treatment by using demographic, clinical and radiological data of patients diagnosed with pneumothorax in the emergency department. MATHERİALS AND METHODS: In our study, which was planned as a retrospective cross-sectional analysis, patients diagnosed with pneumothorax at Yozgat Bozok University Research and Application Hospital Emergency Service between 01/01/2018 and 01/12/2022 were included in the study. In this study where a total of 113 patients were evaluated; Laboratory tests, radiological imaging, medical history (smoking, comorbidities), admission symptoms, vital parameters and other demographic and clinical characteristics of the patients were examined through the hospital system. The results obtained were analyzed by applying statistical tests, their significance was evaluated and reported. RESULTS: Of the 113 patients participating in the study, 85.8% (n = 97) were male and 14.2% (n = 16) were female. The clinical classification of the cases was spontaneous pneumothorax in 51.3% (n = 58); 48.7% (n = 55) were detected as traumatic pneumothorax. 37.2% (n = 42) of the cases were primary spontaneous pneumothorax, 23% (n = 26) were traffic accidents, 18.6% (n = 21) were falls, 14.2% (n = 16) presented with secondary spontaneous pneumothorax, and 7.1% (n = 8) presented with penetrating trauma etiology. The main presenting symptoms of the participants were 60.2% (n = 68) chest pain, 30.1% (n = 34) shortness of breath, 7.1% (n = 8) back pain, and 2.7% (n = 3) were considered unconscious. In the chest radiographs of the patients, pneumothorax was detected in the right hemithorax in 48.7% (n = 55), pneumothorax in the left hemithorax in 45.1% (n = 51), and pneumothorax in both hemithoraxes in 6.2% (n = 7). It was found that patients with Primary Spontaneous Pneumothorax (PSP) were more frequently admitted to the emergency department with chest pain, while patients with Secondary Spontaneous Pneumothorax (SSP) were more frequently admitted with shortness of breath (p < 0.01). Young and elderly groups were compared with the presenting symptoms and pneumothorax subgroups and statistically significant values were obtained (p < 0.01). CONCLUSİON: Pneumthorax is a clinical condition that can be life-threatening. Symptoms such as chest pain and shortness of breath are the main symptoms that suggest pneumothorax. Pneumothorax must be included in the differential diagnosis when evaluating these symptoms in emergency medicine practice. Since it is a disease with a "spontaneous" evaluation in its classification, the symptoms, demographic data, imaging and clinical results of the patients have been a matter of curiosity. The results regarding the effects of the patient's main complaint, smoking, and age, which caused him to come to the emergency department, on the type and size of pneumothorax were evaluated. In addition, parameters related to clinical outcome status, treatment methods, hospitalization type and duration were evaluated together with etiological and radiological data and analyzed in the light of statistical results. This is a study that we believe will be helpful for emergency medicine physicians in the process from symptoms to treatment. KEYWORDS: Pneumothorax, Epidemiology, Volume, PAAC, Treatment