Factors Associated with Duration of Intercostal Chest Drainage in Patients with Primary Spontaneous Pneumothorax and the Role of Pulmonary Rehabilitation

Abstract

Puthachad Namwaing,1 Seksan Chaisuksant,1 Rakfan Sawadpanich,1 Thitima Anukunananchai,1 Akkaranee Timinkul,2 Waraporn Sakaew,3 Bundit Sawunyavisuth,4 Watchara Boonsawat,2 Sittichai Khamsai,2 Kittisak Sawanyawisuth2 1Khon Kaen Regional Hospital, Khon Kaen, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Sittichai Khamsai; Kittisak SawanyawisuthDepartment of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, ThailandTel [phone]Fax [phone]Email [email protected]; [email protected]: Primary spontaneous pneumothorax (PSP) is an urgent/emergency condition. Treatment with intercostal chest drainage (ICD) is necessary, particularly in symptomatic patients or those with tension. A previous study found that systematic breathing exercise significantly reduced ICD duration when compared with controls. This study aimed to evaluate if pulmonary rehabilitation can reduce the duration of ICD treatment in patients with PSP.Patients and Methods: This was a retrospective study of patients diagnosed with PSP treated with ICD. Duration of ICD treatment was recorded from patients’ medical charts. Factors associated with ICD duration were calculated using linear regression analysis.Results: There were 66 patients who met the study criteria, with average (SD) age and body mass index of 31.68 (13.53) years and 20.94 (2.72) kg/m2. The majority of the patients were male (72.73%), and average (SD) duration of ICD treatment was 9.90 (7.83) days. Three factors remained in the final model: body mass index, systolic blood pressure, and recurrent PSP. Two factors were independently associated with longer ICD duration: systolic blood pressure and recurrent PSP, with adjusted coefficients of 0.21 (p value 0.041) and 7.69 (p value 0.039), respectively. Pulmonary rehabilitation was not included in the final model.Conclusion: Patients with a history of recurrent PSP or high systolic blood pressure at presentation may require longer ICD duration. Pulmonary rehabilitation was not associated with the duration of ICD treatment.Keywords: systolic blood pressure, recurrent pneumothorax, body mass index

Keywords

• systolic blood pressure
• recurrent pneumothorax
• body mass index