The incidence, characteristics and outcomes of pneumothorax in thai surgical intensive care units (Thai-SICU study)

Abstract

© 2016, Medical Association of Thailand. All rights reserved. Objective: To identify incidence, characteristics, and outcomes of pneumothorax among patients who specifically stayed in surgical intensive care units (SICUs). Material and Method: This was a multicenter prospective cohort study conducted in 9 University-affiliated SICUs in Thailand. Incidence of pneumothorax and its outcomes were evaluated from April 2011 to January 2013. Results: 4,652 patients who were admitted to SICU were enrolled. The incidence of pneumothorax was 0.5% (25 cases) in our study. Significant characteristics were found in the pneumothorax group, including: lower BMI, underlying malignancy and COPD, higher APACHE-II and SOFA score within 24 hours of first ICU admission, pulmonary infiltration pattern of chest imaging and usage of mechanical ventilation. In terms of outcome, there were higher SICU mortality and 28-day hospital mortality in pneumothorax than non-pneumothorax patients at 28.0% vs. 9.6%, p = 0.002 and at 44.0% vs. 13.6%, p<0.001, respectively. Conclusion: Patients admitted to surgical intensive care units who developed pneumothorax had higher risk of intensive care unit mortality and 28-day hospital mortality than non-pneumothorax patients, as well as a longer intensive care unit and hospital length of stays.