Trends in incidence of pneumothorax in England before, during and after the COVID-19 pandemic (2017–2023): a population-based observational study

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES
Xiaomin Zhong , Raph Goldacre , Eva J.A. Morris , Rob J. Hallifax
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引用次数: 0

Abstract

Background

COVID-19 is a risk factor for pneumothorax. The pandemic may have influenced healthcare-seeking behaviour for pneumothorax. This study aimed to investigate recent trends in the incidence of pneumothorax in England.

Methods

A population-based epidemiological study was conducted using an English national dataset of hospital admissions (Hospital Episode Statistics) from 2017 to 2023. Record-linkage was used to identify multiple admissions per person and co-morbidity. Pneumothoraces co-occurring with COVID-19 were identified by concurrent COVID-19 diagnostic coding. The pre-pandemic (January 2017–February 2020), pandemic (March-2020–February-2021) and post-pandemic periods (March 2021–March 2023) were compared.

Findings

From 2017 to 2023, there were 72,275 hospital admissions for spontaneous pneumothorax among 59,130 patients. Admissions showed marked variability, peaking in January 2021 when the rate of admissions was about two-thirds higher than that of the pre-pandemic level (Incidence rate ratio [IRR] 1.65, 95% CI: 1.48–1.84). However, when excluding patients with a concurrent COVID-19 diagnosis, the overall trend shifted to a reduction during the pandemic period. Post-pandemic rates were not significantly different from pre-pandemic levels (IRR = 0.96, 95% CI: 0.89–1.04). The incidence of spontaneous pneumothorax was significantly higher in males (rate ratio compared to females: 2.29, 95% CI: 2.19–2.39). However, the trends were consistent in both males and females.

Interpretation

This study highlights a significant peak in COVID-19 related cases but a corresponding trough in non-COVID-related cases (end 2020, early 2021). Despite a previous report of increasing incidence of (non-COVID-related) hospitalised spontaneous pneumothorax over the long-term between 1968 and 2016, we did not observe any continued increase throughout this study period, prompting further investigation into the impact of recent guidelines.

Funding

Authors are supported by the NIHR Oxford BRC, Li Ka Shing and Robertson Foundations, MRC, and HDR UK.

COVID-19 大流行之前、期间和之后(2017-2023 年)英格兰气胸发病率趋势:一项基于人口的观察研究
背景COVID-19是气胸的一个危险因素。大流行可能影响了气胸患者的就医行为。本研究旨在调查英格兰气胸发病率的最新趋势。方法利用 2017 年至 2023 年的英格兰全国入院数据集(医院事件统计)开展了一项基于人群的流行病学研究。通过记录关联来识别每人多次入院和共病情况。通过并发的 COVID-19 诊断编码,确定了与 COVID-19 并发的肺炎。对大流行前(2017 年 1 月至 2020 年 2 月)、大流行期(2020 年 3 月至 2021 年 2 月)和大流行后(2021 年 3 月至 2023 年 3 月)进行了比较。研究结果从 2017 年到 2023 年,共有 59130 名患者因自发性气胸入院治疗 72275 次。入院人数有明显的变化,2021 年 1 月达到高峰,入院人数比疫情流行前的水平高出约三分之二(发病率比 [IRR] 1.65,95% CI:1.48-1.84)。然而,如果排除同时诊断为 COVID-19 的患者,大流行期间的总体趋势转为减少。大流行后的发病率与大流行前的发病率没有明显差异(IRR = 0.96,95% CI:0.89-1.04)。男性自发性气胸的发病率明显较高(与女性相比的比率为 2.29,95% CI:2.19-2.39)。本研究强调了 COVID-19 相关病例的显著高峰,但非 COVID 相关病例却出现了相应的低谷(2020 年底,2021 年初)。尽管之前有报告称,1968 年至 2016 年间,(非 COVID 相关的)住院自发性气胸的发病率长期呈上升趋势,但在本研究期间,我们并未观察到任何持续增长的情况,这促使我们进一步调查近期指南的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
19.90
自引率
1.40%
发文量
260
审稿时长
9 weeks
期刊介绍: The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.
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