PDF(Pubmed)
Abstract：
UNASSIGNED: To describe the characteristics of COVID-19 patients with pneumothorax and pneumomediastinum (PTX/PM) and their association with patient outcomes.
UNASSIGNED: Adults admitted to five Mayo Clinic hospitals with COVID-19 between 03/2020-01/2022 were evaluated. PTX/PM was defined by imaging. Descriptive analyses and a matched (age, sex, admission month, COVID-19 severity) cohort comparison was performed. Hospital mortality, length of stay (LOS), and predisposing factors were assessed.
UNASSIGNED: Among 6663 patients, 197 had PTX/PM (3 %) (75 PM, 40 PTX, 82 both). The median age was 59, with 71 % males. Exposure to invasive and non-invasive mechanical ventilation and high-flow nasal cannula before PTX/PM were 42 %, 17 %, and 20 %, respectively. Among isolated PTX and PM/PTX patients 70 % and 53.7 % underwent an intervention, respectively, while 96 % of the PM-only group was followed conservatively.A total of 171 patients with PTX/PM were compared to 171 matched controls. PTX/PM patients had more underlying lung disease (40.9 vs. 23.4 %, p < 0.001) and lower median body mass index (BMI) (29.5 vs. 31.3 kg/m2, p = .007) than controls. Among patients with available data, PTX/PM patients had higher median positive end-expiratory and plateau pressures than controls; however, differences were not significant (10 vs. 8 cmH2O; p = 0.38 and 28 vs. 22 cmH2O; p = 0.11, respectively). PTX/PM patients had a higher odds of mortality (adjusted odds ratio [95%CI]: 3.37 [1.61-7.07]) and longer mean LOS (percent change [95%CI]: 39 [9-77]) than controls.
UNASSIGNED: In COVID-19 patients with similar severity, PTX/PM patients had more underlying lung disease and lower BMI. They had significantly increased mortality and LOS.
UNASSIGNED: Adults admitted to five Mayo Clinic hospitals with COVID-19 between 03/2020-01/2022 were evaluated. PTX/PM was defined by imaging. Descriptive analyses and a matched (age, sex, admission month, COVID-19 severity) cohort comparison was performed. Hospital mortality, length of stay (LOS), and predisposing factors were assessed.
UNASSIGNED: Among 6663 patients, 197 had PTX/PM (3 %) (75 PM, 40 PTX, 82 both). The median age was 59, with 71 % males. Exposure to invasive and non-invasive mechanical ventilation and high-flow nasal cannula before PTX/PM were 42 %, 17 %, and 20 %, respectively. Among isolated PTX and PM/PTX patients 70 % and 53.7 % underwent an intervention, respectively, while 96 % of the PM-only group was followed conservatively.A total of 171 patients with PTX/PM were compared to 171 matched controls. PTX/PM patients had more underlying lung disease (40.9 vs. 23.4 %, p < 0.001) and lower median body mass index (BMI) (29.5 vs. 31.3 kg/m2, p = .007) than controls. Among patients with available data, PTX/PM patients had higher median positive end-expiratory and plateau pressures than controls; however, differences were not significant (10 vs. 8 cmH2O; p = 0.38 and 28 vs. 22 cmH2O; p = 0.11, respectively). PTX/PM patients had a higher odds of mortality (adjusted odds ratio [95%CI]: 3.37 [1.61-7.07]) and longer mean LOS (percent change [95%CI]: 39 [9-77]) than controls.
UNASSIGNED: In COVID-19 patients with similar severity, PTX/PM patients had more underlying lung disease and lower BMI. They had significantly increased mortality and LOS.
摘要：
■描述COVID-19气胸和纵隔气肿（PTX/PM）患者的特征及其与患者预后的关系。
■对2020年03月1日至2022年01月在五家梅奥诊所住院的患有COVID-19的成年人进行了评估。PTX/PM通过成像确定。描述性分析和匹配的(年龄，性别,入学月,进行COVID-19严重程度）队列比较。医院死亡率，停留时间(LOS)并评估了诱发因素。
■在6663名患者中，197有PTX/PM（3%）（75PM，40PTX,82两者）。中位年龄为59岁，男性占71％。PTX/PM前有创和无创机械通气和高流量鼻插管的暴露率为42％，17%,20%,分别。在孤立的PTX和PM/PTX患者中，70%和53.7%接受了干预，分别,而仅PM组的96％被保守跟踪。将171名PTX/PM患者与171名匹配的对照进行比较。PTX/PM患者有更多的潜在肺部疾病（40.9与23.4%,p<0.001）和较低的中位体重指数（BMI）（29.5vs.31.3kg/m2，p=.007）比对照。在有可用数据的患者中，PTX/PM患者的呼气末正压和平台压中位数高于对照组；然而，差异不显著(10vs.8cmH2O；p=0.38和28vs.22cmH2O；分别为p=0.11）。与对照组相比，PTX/PM患者的死亡率较高（调整后比值比[95CI]：3.37[1.61-7.07]）和平均LOS较长（变化百分比[95CI]：39[9-77]）。
■在严重程度相似的COVID-19患者中，PTX/PM患者有更多的潜在肺部疾病和更低的BMI。他们的死亡率和LOS显着增加。
■对2020年03月1日至2022年01月在五家梅奥诊所住院的患有COVID-19的成年人进行了评估。PTX/PM通过成像确定。描述性分析和匹配的(年龄，性别,入学月,进行COVID-19严重程度）队列比较。医院死亡率，停留时间(LOS)并评估了诱发因素。
■在6663名患者中，197有PTX/PM（3%）（75PM，40PTX,82两者）。中位年龄为59岁，男性占71％。PTX/PM前有创和无创机械通气和高流量鼻插管的暴露率为42％，17%,20%,分别。在孤立的PTX和PM/PTX患者中，70%和53.7%接受了干预，分别,而仅PM组的96％被保守跟踪。将171名PTX/PM患者与171名匹配的对照进行比较。PTX/PM患者有更多的潜在肺部疾病（40.9与23.4%,p<0.001）和较低的中位体重指数（BMI）（29.5vs.31.3kg/m2，p=.007）比对照。在有可用数据的患者中，PTX/PM患者的呼气末正压和平台压中位数高于对照组；然而，差异不显著(10vs.8cmH2O；p=0.38和28vs.22cmH2O；分别为p=0.11）。与对照组相比，PTX/PM患者的死亡率较高（调整后比值比[95CI]：3.37[1.61-7.07]）和平均LOS较长（变化百分比[95CI]：39[9-77]）。
■在严重程度相似的COVID-19患者中，PTX/PM患者有更多的潜在肺部疾病和更低的BMI。他们的死亡率和LOS显着增加。
