HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Google Scholar Articles by Kelly, A.-M. Articles by Clooney, M. PubMed PubMed Citation Articles by Kelly, A.-M. Articles by Clooney, M.

Outcomes of emergency department patients treated for primary spontaneous pneumothorax

Anne-Maree Kelly MD FACEM, Joseph Epstein Centre for Emergency Medicine Research, Western Health and The University of Melbourne; Debra Kerr BN MBL, Joseph Epstein Centre for Emergency Medicine Research, Western Health and The University of Melbourne; Megan Clooney RN, Joseph Epstein Centre for Emergency Medicine Research, Western Health

Anne-Maree.Kelly{at}wh.org.au

Abstract

BackgroundInternational guidelines for the management of primary spontaneous pneumothorax [PSP] vary and there is growing opinion that more patients could be successfully managed with observation alone. There is little published evidence detailing outcomes of ED patients treated for PSP. The aim of this study was to describe the clinical outcomes for patients with PSP.

MethodsThis was a retrospective cohort study conducted by explicit medical record review that investigated adult patients with PSP treated at 2 urban teaching hospital EDs between 1996-2005. Data collected included demographics, clinical data at presentation and outcome data. The outcome of interest was the proportion successfully treated with the initial management strategy [conservative, aspiration, tube thoracostomy]. Data analysis is by descriptive statistics.

Results203 episodes of PSP in 154 patients were identified; 70% male, median age 24 years. PSP size ranged from 5-100%. 91 PSP [45%] were treated with outpatient observation, 48 [24%] with aspiration and 64 [31%] with tube thoracostomy. 79% [82/91] of patients treated with observation resolved without additional intervention. Aspiration was successful in 50% [24/48] of cases where it was attempted. 73% of PSP treated with tube thoracostomy [47/64] resolved without additional intervention.

ConclusionThis data suggests that observation alone is an effective initial treatment strategy for selected patients with PSP. It supports the inclusion of an observation arm in planned prospective studies comparing different management approaches.

Key Words: Pneumothorax • management