Risk factors for mediastinitis and mortality in pneumomediastinum

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-03-15 DOI:10.34172/jcvtr.2022.09

H. Dirol, H. Keskin

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引用次数: 3

Abstract

Introduction: Pneumomediastinum (PM) is a self-limiting disease with a good prognosis. Mediastinitis is a rare but potentially fatal complication of PM. Identification of risk factors for mediastinitis is essential for better management. Methods: This is a single-center, retrospective study conducted in a university hospital. Adult patients with PM between January 2016 and June 2020 were involved in the study. The data about age, gender, symptoms, signs, treatment, development of mediastinitis, hospital stay, and mortality were investigated. Results: In total, 79 patients with PM were analyzed. The most common symptom was dyspnea(58;73.4%) and the most common sign was subcutaneous emphysema (48;60.7%). Thirty(37.9%) of them were iatrogenic PM (IPM), while 22 (27.9%) were spontaneous PM (SPM) and27 (34.2%) were traumatic PM (TPM). Mediastinitis developed in 17 (12 from IPM, 4 from TPM,1 from SPM) patients, and 11 (58.8%) of these patients died. The incidence of mediastinitis in the IPM group was significantly higher than in the TPM and SPM group (respectively, P = 0,03,P = 0,01). There was no significant difference between the age, gender, symptoms, and signs of those with or without mediastinitis. Mortality was lower in TPM and SPM than IPM (respectively,P = 0,05, P = 0,03), and hematological malignancy was remarkably common in patients who died from mediastinitis in the TPM and SPM group. Conclusion: Mediastinitis and mortality were significantly higher in IPM, while hematological malignancy was remarkably prevalent in patients deceased from mediastinitis in TPM and SPM.

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纵隔肺炎患者纵隔炎和死亡率的危险因素

简介：纵隔肺炎是一种自限性疾病，预后良好。纵隔炎是PM的一种罕见但可能致命的并发症。识别纵隔炎的危险因素对于更好的治疗至关重要。方法：这是一项在大学医院进行的单中心回顾性研究。2016年1月至2020年6月期间患有PM的成年患者参与了这项研究。对年龄、性别、症状、体征、治疗、纵隔炎的发展、住院时间和死亡率等数据进行了调查。结果：共分析了79例PM患者。最常见的症状是呼吸困难（58；73.4%），最常见的体征是皮下气肿（48；60.7%）。其中30例（37.9%）为医源性PM，22例（27.9%）为自发性PM，27例（34.2%）为创伤性PM。17名（12名来自IPM，4名来自TPM，1名来自SPM）患者出现纵隔炎，其中11名（58.8%）患者死亡。IPM组纵隔炎的发生率显著高于TPM和SPM组（分别为P=0.03，P=0.01）。患有或不患有纵隔炎的患者的年龄、性别、症状和体征之间没有显著差异。TPM组和SPM组的死亡率低于IPM组（分别为P=0.05，P=0.03），血液系统恶性肿瘤在死于纵隔炎的患者中非常常见。结论：IPM患者纵隔炎和死亡率明显较高，而血液系统恶性肿瘤在TPM和SPM患者死于纵隔炎的患者中显著流行。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.