PDF(Pubmed)
Abstract：
UNASSIGNED: Pneumothorax is a rare but deadly complication in patients who require mechanical ventilation. As with any condition associated with acute respiratory distress syndrome (ARDS), coronavirus disease 2019 (COVID-19) is known to be associated with pneumothorax. However, in the literature, comparative data on the risk factors for pneumothorax in COVID-19 and other diseases like influenza are limited. The aim of this study is to determine the prevalence and risk factors for pneumothorax in hospitalized COVID-19 patients and compare them with influenza pneumonia patients.
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.
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.
摘要：
■气胸是需要机械通气的患者的一种罕见但致命的并发症。与任何与急性呼吸窘迫综合征（ARDS）相关的疾病一样，已知2019年冠状病毒病（COVID-19）与气胸有关。然而,在文学中,关于COVID-19和流感等其他疾病的气胸危险因素的比较数据有限。这项研究的目的是确定住院COVID-19患者气胸的患病率和危险因素，并将其与流感肺炎患者进行比较。
■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。
■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。
