Analysis of patients with pneumothorax admitted to Duzce University School of Medicine Department of emergency medicine

ANALYSIS OF PATIENTS WITH PNEUMOTHORAX ADMITTED TO DUZCE UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF EMERGENCY MEDICINE Introduction and Objectives: Pneumothorax (PNX) is defined as the formation of free air in the space between the parietal and visceral membranes of the lung and associated with collapse of the lung. Pneumothorax, which is one of the significant disorders included in the differential diagnosis of patients presenting to emergency departments with complaints like shortness of breath and chest pain, can lead to life-threatening consequences. A detailed retrospective analysis of pneumothorax cases was conducted. It was aimed to help physicians with diagnosis, treatment, observation and prediction of prognosis in daily emergency department practice. Matherials and Methods: Totally 147 pneumothorax cases, who were at least 18 years old, admitted to Düzce University School of Medicine Department of Emergency Medicine between April 1st, 2014 and April 1st, 2017 were recruited into the study. The study was designed as a retrospective cross–sectional study. The patients' physical examination findings, medical history, ECGs, the results of routine blood tests, direct X – ray and tomographic findings, treatments given, duration of hospitalization and out-patient follow–up were examined using the hospital data–proccessing system, patient files and archive data. Significance of the acquired data was evaluated by various statistical tests. v Results: Among 147 participiants 84,4% (n=130) were male; 32,7% (n=48) were traffic accident cases; 25,9% (n=38) were spontaneous pneumothorax; 23,1% (n=34) were formed by cases of fall, and 18,4% were admitted to the emergency department due to another urgent condition. PA chest X- Ray was evaluated to be normal in 16,3% (n=24) of of the patients; it showed right-sided pneumothorax in 32,0% (n=47), and left-sided pneumothorax in 16,3% (n=24). Thoracic CT showed rightsided pneumothorax in 48,2% (n=71), left-sided pneumothorax in 42,8% (n=63) and bilateral pneumothorax in 8,8% (n=13) of the patients. Patients with spontaneous pneumothorax were more likely to have a pneumothorax filling more than 20% of the hemithorax (p <0,001). Besides, those patients had abnormal findings more frequently on the ECG taken on admission (p=0,004). Conclusion: Pneumothorax is a significant clinical condition necessitating emergent treatment. All phsycians can encounter a case of pneumothorax, and emergency department physicians should not overlook this significant pathology. Various treatment methods including observation with oxygen support, needle aspiration, percutaneous aspiration catheter, tube thoracostomy, VATS and thoracotomy are used in the treatment of pneumothorax. Therapeutic decision depends on the underlying reason and size of the pneumothorax and clinical condition of the patient. The aim of the treatment is to provide complete re-expension of the lung, to remove the symptoms and prevent complications and recurrences. Keywords: Pneumothorax, Size, ECG, PA Chest X-Ray, Treatment