Predicting Factors of Persistent Air Leaks after traumatic Pneumothorax

Abdessalem H, Mohamed R, Ahmed BA, Ghassen BH, Zied C and Imed F

Published on: 2023-09-29

Abstract

Background

Traumatic Pneumothorax [TPT] is an emergency. Many factors make the management problematic, especially in persistent air leaks [PAL]. Not many studies have focused on these factors after a TPT. Our study aims to identify the predictors of PAL in TPT to set a strategy for managing this type of Pneumothorax.

Methods

Retrospective study including patients who were hospitalized for a TPT in the Thoracic and Cardiovascular Department of the Habib BOURGUIBA’s Hospital in Sfax, Tunisia, from January 2010 to December 2021. The statistical analysis consisted of the search for correlation between the different variables of the study by Chi2. A multi-variate study by logistic regression was also performed to determine the predictive and prognostic factors.

Results

Over 12 years, 375 patients presented a TPT. The average age was 40 years. Placement of a chest tube was indicated in 221 cases [58.9%]. Eighty Nine patients [43%] underwent a chest tube in the intensive care unit, and 104 patients [50.24%], were managed by thoracic surgeons. Fourteen patients [6.76%] underwent a chest tube in other regional hospitals and were referred to us. The average drainage time was 4 days. PAL was found in 36 cases [16.2%]. A correlation was found between the number of Packet-years [PY] and the PAL after chest tube placement. Indeed, PY >10 is a risk factor for prolonged air leaks. It was shown in our study that chest tube placement if done in the emergency room, under non-optimal conditions, exposed 2.6 times to PAL [OR=2.687, CI=95%, 1.226-5.889]. No influence was noted between the genders, age, and the existence or not of a penetrating wound or the existence or not of associated chest injuries on the duration of air leaks when a chest tube was put in.

Conclusion

This work has proven that smoking and the no optimal conditions of chest tube placement, are predictors of PAL. These factors can be considered to define a strategy for managing this kind of injury.