PDF(Pubmed)
Abstract：
We aimed to determine the clinical characteristics of patient self-inflicted lung injury (P-SILI)-associated pneumothorax/pneumomediastinum, to reveal its risk factors, and to assess its impact on severe COVID-19 cases. In total, 229 patients were included in this case-control study. They were randomly divided into either the case group or the control group as per the inclusion and exclusion criteria. The two groups were further analyzed to reveal the risk factors of spontaneous pneumothorax/pneumomediastinum (SP/P). Finally, risk factors for death were analyzed in the case group and the relationship between death and SP/P was also analyzed among all patients. The mean age of patients was 59.69 ± 17.01 years, most of them were male (74.2%), and 62.0% of them had comorbidities upon admission. A respiratory rate higher than 30 BPM was a risk factor for SP/P (OR 7.186, 95% CI 2.414-21.391, P < 0.001). Patients with delayed intubation due to early application of HFNC or NIV had a higher mortality rate when they developed SP/P (P < 0.05). Additionally, advanced age increased the risk of death (P < 0.05). Finally, SP/P may be a risk factor for death among patients with severe COVID-19 (OR 2.047). P-SILI occurs in severe COVID-19 with acute respiratory failure. It is necessary to identify the risk factors of P-SILI, the indicators of severe P-SILI, and the preventive measures.
摘要：
我们旨在确定患者自身造成的肺损伤（P-SILI）相关气胸/纵隔气胸的临床特征，为了揭示其风险因素，并评估其对严重COVID-19病例的影响。总的来说,本病例对照研究包括229例患者。根据纳入和排除标准，将其随机分为病例组和对照组。进一步分析两组自发性气胸/纵隔气胸(SP/P)的危险因素。最后,分析病例组死亡的危险因素,并分析所有患者死亡与SP/P的关系.患者平均年龄为59.69±17.01岁,其中大多数是男性(74.2%)，其中62.0%在入院时有合并症。呼吸频率高于30BPM是SP/P的危险因素（OR7.186，95％CI2.414-21.391，P<0.001）。早期应用HFNC或NIV导致延迟插管的患者出现SP/P时死亡率较高(P<0.05)。此外,高龄增加死亡风险(P<0.05)。最后,SP/P可能是重症COVID-19患者死亡的危险因素(OR2.047)。P-SILI发生于严重的COVID-19伴急性呼吸衰竭。有必要识别P-SILI的危险因素，严重P-SILI的指标，以及预防措施。
