UNASSIGNED: This study is a retrospective analysis of the National Inpatient Sample (NIS) 2020 database cohort. Univariate and multivariate logistic regression were used to identify the prevalence and risk factors for pneumothorax in COVID-19 patients and compared with the risk of pneumothorax in influenza patients.
UNASSIGNED: The NIS 2020 database includes 1,608,980 hospitalizations of COVID-19 patients, of which 22,545 [95% confidence interval (CI): 21,491-23,598] (1.4%) developed pneumothorax. On multivariate analysis, factors associated with pneumothorax in COVID-19 included patient age of 41-64 years; male sex; Hispanics, Native Americans, and other races; hospitals with large-bed size; privately owned hospitals; urban teaching hospitals; hospitals in the southern United States (US); stroke; malnutrition; chronic obstructive pulmonary disease (COPD); bronchiectasis; pulmonary fibrosis; liver disease; non-invasive and invasive ventilation; and extracorporeal membrane oxygenation (ECMO). Of 184,980 influenza patients, 1,630 (95% CI: 1,448-1,811) (0.88%) developed pneumothorax. The prevalence of pneumothorax was higher (1.4%) in COVID-19 patients compared to patients with influenza pneumonia (0.88%).
UNASSIGNED: COVID-19 patients who develop pneumothorax have a poor prognosis. Several risk factors for the development of pneumothorax were identified. Patients with these risk factors should be prioritized in applying evidence-based guidelines to prevent pneumothorax.
■本研究是对国家住院患者样本(NIS)2020数据库队列的回顾性分析。采用单因素和多因素logistic回归分析COVID-19患者气胸的患病率和危险因素,并与流感患者气胸的风险进行比较。
■NIS2020数据库包括1,608,980例COVID-19患者的住院治疗,其中22,545[95%置信区间(CI):21,491-23,598](1.4%)发生气胸。在多变量分析中,与COVID-19气胸相关的因素包括41-64岁的患者;男性;西班牙裔,美洲原住民,和其他种族;大型病床的医院;私人医院;城市教学医院;美国南部的医院(US);中风;营养不良;慢性阻塞性肺疾病(COPD);支气管扩张;肺纤维化;肝病;无创和有创通气;和体外膜氧合(ECMO)。在184,980名流感患者中,1,630(95%CI:1,448-1,811)(0.88%)发生气胸。与流感肺炎患者(0.88%)相比,COVID-19患者的气胸患病率更高(1.4%)。
■发生气胸的COVID-19患者预后不良。确定了气胸发展的几种危险因素。有这些危险因素的患者在应用循证指南预防气胸时应优先考虑。