The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage

Abstract Small-bore thoracic catheter drainage is recommended for a first large or symptomatic episode of primary spontaneous pneumothorax (PSP). However, one-third of these patients require a second procedure because of treatment failure. We investigated the factors associated with unsuccessful pig...

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Autores principales:	Tung-Ming Tsai, Mong-Wei Lin, Yao-Jen Li, Chin-Hao Chang, Hsien-Chi Liao, Chao-Yu Liu, Hsao-Hsun Hsu, Jin-Shing Chen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/725f9d0fc58441609a59ac03c37de09a
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spelling	oai:doaj.org-article:725f9d0fc58441609a59ac03c37de09a2021-12-02T11:52:58ZThe Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage10.1038/s41598-017-00284-82045-2322https://doaj.org/article/725f9d0fc58441609a59ac03c37de09a2017-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-00284-8https://doaj.org/toc/2045-2322Abstract Small-bore thoracic catheter drainage is recommended for a first large or symptomatic episode of primary spontaneous pneumothorax (PSP). However, one-third of these patients require a second procedure because of treatment failure. We investigated the factors associated with unsuccessful pigtail catheter drainage in the management of PSP. In this retrospective study, using a prospectively collected database, we enrolled 253 consecutive patients with PSP who underwent pigtail catheter drainage as initial treatment, from December 2006 to June 2011. The chest radiograph was reviewed in each case and pneumothorax size was estimated according to Light’s index. Other demographic factors and laboratory data were collected via chart review. Pigtail catheter drainage was successful in 71.9% (182/253) of cases. Treatment failure rates were 42.9%, 25.9%, and 15.5% in patients with pneumothorax sizes of >62.6%, 38–62.6%, and <38%, respectively (tertiles). An alternative cut-off point of 92.5% lung collapse was defined using a classification and regression tree method. According to the multivariate analysis, a large-size pneumothorax (p = 0.009) was the only significant predictor of initial pigtail catheter drainage treatment failure in patients with PSP. Early surgical treatment could be considered for those patients with a large-sized pneumothorax.Tung-Ming TsaiMong-Wei LinYao-Jen LiChin-Hao ChangHsien-Chi LiaoChao-Yu LiuHsao-Hsun HsuJin-Shing ChenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-7 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tung-Ming Tsai Mong-Wei Lin Yao-Jen Li Chin-Hao Chang Hsien-Chi Liao Chao-Yu Liu Hsao-Hsun Hsu Jin-Shing Chen The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
description	Abstract Small-bore thoracic catheter drainage is recommended for a first large or symptomatic episode of primary spontaneous pneumothorax (PSP). However, one-third of these patients require a second procedure because of treatment failure. We investigated the factors associated with unsuccessful pigtail catheter drainage in the management of PSP. In this retrospective study, using a prospectively collected database, we enrolled 253 consecutive patients with PSP who underwent pigtail catheter drainage as initial treatment, from December 2006 to June 2011. The chest radiograph was reviewed in each case and pneumothorax size was estimated according to Light’s index. Other demographic factors and laboratory data were collected via chart review. Pigtail catheter drainage was successful in 71.9% (182/253) of cases. Treatment failure rates were 42.9%, 25.9%, and 15.5% in patients with pneumothorax sizes of >62.6%, 38–62.6%, and <38%, respectively (tertiles). An alternative cut-off point of 92.5% lung collapse was defined using a classification and regression tree method. According to the multivariate analysis, a large-size pneumothorax (p = 0.009) was the only significant predictor of initial pigtail catheter drainage treatment failure in patients with PSP. Early surgical treatment could be considered for those patients with a large-sized pneumothorax.
format	article
author	Tung-Ming Tsai Mong-Wei Lin Yao-Jen Li Chin-Hao Chang Hsien-Chi Liao Chao-Yu Liu Hsao-Hsun Hsu Jin-Shing Chen
author_facet	Tung-Ming Tsai Mong-Wei Lin Yao-Jen Li Chin-Hao Chang Hsien-Chi Liao Chao-Yu Liu Hsao-Hsun Hsu Jin-Shing Chen
author_sort	Tung-Ming Tsai
title	The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
title_short	The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
title_full	The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
title_fullStr	The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
title_full_unstemmed	The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage
title_sort	size of spontaneous pneumothorax is a predictor of unsuccessful catheter drainage
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/725f9d0fc58441609a59ac03c37de09a
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The Size of Spontaneous Pneumothorax is a Predictor of Unsuccessful Catheter Drainage

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