预测原发性自发性气胸的复发:哈勒指数在急诊科患者中的作用。

Ömerul Faruk Aydın, Ali Cankut Tatlıparmak
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引用次数: 0

摘要

背景:原发性自发性气胸(PSP)是急诊科常见的疾病,通常影响年轻人,其他方面健康的个体。识别有复发风险的患者对于优化治疗策略和预防并发症至关重要。本研究旨在评估Haller指数在诊断为PSP患者复发风险方面的预测价值。方法:对某三级医院急诊科2019年1月1日至2024年1月1日诊断为PSP的患者进行回顾性分析。患者被分为两组:经历一次PSP发作的患者和复发性气胸患者。采用倾向评分匹配来控制混杂因素,包括年龄、性别、吸烟状况和体重指数(BMI)。通过胸部计算机断层扫描(CT)计算Haller指数,并使用受试者工作特征(ROC)曲线分析评估其预测复发的准确性。结果:共纳入182例患者,经倾向评分匹配后,每组91例。复发性气胸组的Haller指数(2.72+-0.47)明显高于单纯气胸组(2.15+-0.34),平均差异为0.56(95%可信区间[CI]: 0.44-0.69, p2.38)。结论:Haller指数是预测PSP患者复发性气胸的重要指标。将其整合到临床评估中可以帮助识别复发风险较高的患者,从而制定量身定制的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting recurrence in primary spontaneous pneumothorax: The role of the Haller index in emergency department patients.

Background: Primary spontaneous pneumothorax (PSP) is a common condition encountered in emergency departments, typically affecting young, otherwise healthy individuals. Identifying patients at risk for recurrence is critical for optimizing management strategies and preventing complications. This study aimed to evaluate the predictive value of the Haller index in determining the risk of recurrence in patients diagnosed with PSP.

Methods: A retrospective analysis was conducted on patients diagnosed with PSP between January 1, 2019 and January 1, 2024, in the emergency department of a tertiary care hospital. Patients were categorized into two groups: those experiencing a single PSP episode and those with recurrent pneumothorax. Propensity score matching was employed to control for confounders, including age, gender, smoking status, and body mass index (BMI). The Haller index was calculated from chest computed tomography (CT) scans, and its predictive accuracy for recurrence was evaluated using Receiver Operating Characteristic (ROC) curve analysis.

Results: A total of 182 patients were included in the study, with 91 patients in each group after propensity score matching. The Haller index was significantly higher in the recurrent pneumothorax group (2.72+-0.47) compared to the single pneumothorax group (2.15+-0.34), with a mean difference of 0.56 (95% confidence interval [CI]: 0.44-0.69, p<0.001). ROC analysis demonstrated an area under the curve (AUC) of 0.830 (95% CI: 0.768-0.882), with a Youden index of 0.50, sensitivity of 72.53%, and specificity of 76.92% for a cutoff value of >2.38.

Conclusion: The Haller index is a strong predictor of recurrent pneumothorax in patients with PSP. Its integration into clinical assessments can help identify patients at elevated risk of recurrence, enabling tailored treatment strategies.

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