Pneumothorax in cystic fibrosis
Pneumothorax in cystic fibrosis
复制标题
DOI：
10.1378/chest.128.2.720
复制
发表时间：
2005-08-01
期刊：
影响因子：
9.6
通讯作者：
Clark, LL
中科院分区：
文献类型：
--
作者：
Flume, PA;Strange, C;Clark, LL
背景：自发性气胸是囊性纤维化（CF）患者常见的并发症。目的：确定与气胸相关的危险因素，并确定气胸发作后CF患者的预后。设计：1990年至1999年国家囊性纤维化患者登记处的回顾性观察队列研究。患者：该登记处包含了28,858例CF患者的数据，这些患者在美国CF中心接受了10年的随访。结果：气胸的平均年发病率为0.64%，总发病率为3.4%。性别之间的发生率没有增加，但CF在老年患者（平均[+/- SD]年龄，21.9 +/- 9.1岁）和更严重的肺功能损害（近75%的患者FEV 1 < 40%预测值）中更普遍。与气胸发生率增加相关的主要风险包括铜绿假单胞菌的存在（比值比[OR]，2.3），洋葱伯克霍尔德菌（OR，1.8），或曲霉属（OR，1.3）在痰培养中，FEVI < 30%预测值（OR，1.5）、肠内喂养（OR，1.7）、医疗补助保险（OR，1.1）、胰腺功能不全（OR，1.4）、过敏性支气管肺炎曲霉菌病（OR，1.5）和大咯血（OR，1.4）。有一个增加的发病率（例如，增加住院人数和住院天数）和增加2年的死亡率pneumotretrieval.Conclusion：气胸是一种严重的并发症CF患者，更常见于老年患者更先进的肺部疾病。每年167例患者中有近1例会出现这种并发症。有一个归因于并发症的死亡率和相当大的发病率，导致医疗保健利用率增加和肺功能的可衡量的下降。
Background: Spontaneous pneumothorax is a complication that is commonly reported in patients with cystic fibrosis (CF). An understanding of the pathophysiology of this complication and its consequences is important for the management of patients with CF.Objective: To identify risk factors associated with pneumothorax and to determine the prognosis of CF patients following an episode of pneumothorax.Design: A retrospective observational cohort study of the National Cystic Fibrosis Patient Registry between the years 1990 and 1999.Patients: The registry contained data on 28,858 patients with CF who had been followed up over those10 years at CF centers across the United States.Results: Pneumothorax occurred with an average annual incidence of 0.64% and in 3.4% of patients overall. There was no increased occurrence by sex, but CF was more prevalent in older patients (mean [+/- SD] age, 21.9 +/- 9.1 years) with more severe pulmonary impairment (nearly 75% of patients with FEV1, of < 40% predicted). The principal risks associated with an increased occurrence of pneumothorax included the presence of Pseudomonas aeruginosa (odds ratio [OR], 2.3), Burkholderia cepacia (OR, 1.8), or Aspergillus (OR, 1.3) in sputum cultures, FEVI < 30% predicted (OR, 1.5), enteral feeding (OR, 1.7), Medicaid insurance (OR, 1.1), pancreatic insufficiency (OR, 1.4), allergic bronchopulmonary aspergillosis (OR, 1.5), and massive hemoptysis (OR, 1.4). There is an increased morbidity (eg, increased number of hospitalizations and number of days spent in the hospital) and an increased 2-year mortality rate following pneumotborax.Conclusion: Pneumothorax is a serious complication in CF patients, occurring more commonly in older patients with more advanced lung disease. Nearly I in 167 patients will experience this complication each year. There is an attributable mortality to the complication and considerable morbidity, resulting in increased health-care utilization and a measurable decline in lung function.