Retrospective analysis of iatrogenic pneumothorax cases evaluated in the emergency department

Retrospective Analysis of Iatrogenic Pneumothorax Cases Evaluated in the Emergency Department Objective: The aim of our study is to assist the physician in the diagnosis, appropriate treatment, follow-up and prognosis prediction by performing a retrospective detailed analysis of cases with iatrogenic pneumothorax admitted to the emergency department. Material and Method: Our study was carried out by compiling the radiological images and archive file data of patients diagnosed with iatrogenic pneumothorax in the Emergency Medicine Department of Çukurova University Faculty of Medicine between June 1, 2017 and June 1, 2020. Results: 61 patients were included in the study. The average age of the patients is 63.49 ± 15.11 years, 51 of them are male. The most common complaint at presentation was shortness of breath (n = 49, 80 %), and the most common physical examination finding was subcutaneous emphysema (n = 20, 32.8 %). The most common interventional procedures that cause iatrogenic pneumothorax are transthoracic fine needle aspiration (n = 41, 67.2 %), tru-cut biopsy (n = 10, 16.4 %) and thoracentesis (n = 5, 8.2 %). Most of the patients were diagnosed with chest radiography (n = 36, 59 %). Thirty-three patients (54 %) with pneumothorax have lung cancer (p> 0.05). No difference was found between the procedure area causing pneumothorax and the cost. Therewithal, no difference was found between the procedure area causing pneumothorax and the number of radiological imaging sections applied during diagnosis and follow-up (p> 0.05). Costs of patients who were treated in the left lung anterior region were found to be higher (p = 0.035). During the follow-up, most of the patients were followed up with chest radiography (n = 48). Costs and length of hospital stay of the patients followed up with computed tomography were found to be higher (p = 0.034, p = 0.049). Chest tube treatment was applied to 33 patients (54.1 %). It was found that the hospitalization periods of the patients who underwent chest tube treatment were longer and their costs were higher (p = 0,000). Less than 20% of the pneumothorax area was detected in 33 patients (54.1 %). Also, all of the patients who did not have a chest tube (n = 28, 45.9 %) are included in this group. As a result of the follow-up, only one patient died in the intensive care unit due to pneumonia and septic shock. The average cost of patients with iatrogenic pneumothorax was found to be 1070 TL per person. It was found that as the percentage of pneumothorax increased, the total cost and the number of days of hospitalization increased (p = 0.000, p = 0.003, respectively). Conclusion: According to the information we obtained as a result of the study, development of iatrogenic pneumothorax; It is a medical condition that prolongs hospital stay, increases patient costs, and increases the need for additional imaging. Key Words: Emergency Department, İatrogenic Pneumothorax, Cost, Radiologic Imaging