Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients
| Autor: | Takao Nakanishi, Mitsugu Omasa, Shunichi Nagata, Kosuke Tokushige, Hideki Motoyama |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Postoperative Complications Recurrence Risk Factors Odds Ratio Humans Medicine In patient Risk factor Survival rate Pleurodesis Aged Retrospective Studies Aged 80 and over Performance status Thoracic Surgery Video-Assisted business.industry Patient Selection Mortality rate Age Factors Pneumothorax Odds ratio medicine.disease Confidence interval Surgery Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. |
| ISSN: | 1569-9285 |
| DOI: | 10.1093/icvts/ivz252 |
| Popis: | OBJECTIVES There is no clear consensus on the surgical indications for spontaneous pneumothorax in elderly patients. In this study, we aimed to assess the efficacy and safety of surgical treatment of spontaneous pneumothorax in patients aged ≥70 years. We also sought to identify the risk factors for postoperative prolonged air leaks and complications in such patients. METHODS Data pertaining to 104 elderly patients who underwent surgery out of 206 patients (aged ≥70 years) who were diagnosed with spontaneous pneumothorax at our institution between 1994 and 2018 were retrospectively reviewed. The incidences of postoperative persistent air leaks (≥2 days) and postoperative complications (≥grade 3; Clavien–Dindo classification) were analysed for efficacy and safety assessment, respectively. RESULTS Median postoperative air leaks continued for 0 days (range 0–25); 14.4% patients developed ≥grade 3 postoperative complications. On the basis of results of multivariable analysis, it was observed that a higher PaCO2 level was significantly associated with prolonged postoperative air leaks [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.00–1.17; P = 0.047]. Poorer performance status was associated with a significantly increased risk of postoperative complications, as assessed by multivariable analysis (OR 6.13, 95% CI 1.38–27.3; P = 0.017). The recurrence rate was 4.8%; mortality rate of patients was 2.9%. Three-year survival rate after surgery was 73.8%. CONCLUSIONS Surgical treatment of spontaneous pneumothorax may be effective and safe in selected elderly patients. Moreover, higher PaCO2 and poorer performance status were independent risk factors for postoperative persistent air leaks and complications, respectively. |
| Databáze: | OpenAIRE |
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