Abstract
BackgroundSome patients with idiopathic pulmonary fibrosis (IPF) develop pneumothorax. However, the characteristics of pneumothorax in patients with IPF have not been elucidated. The purpose of this study was to clarify the clinical course, actual management, and treatment outcomes of pneumothorax in patients with IPF.MethodsConsecutive patients with IPF who were admitted for pneumothorax between January 2008 and December 2018 were included. The success rates of treatment for pneumothorax, hospital mortality, and recurrence rate after discharge were examined.ResultsDuring the study period, 36 patients with IPF were admitted with pneumothorax a total of 58 times. During the first admission, 15 patients (41.7%) did not receive chest tube drainage, but 21 (58.3%) did. Of the 21 patients, 8 (38.1%) received additional therapy after chest drainage. The respective treatment success rates were 86.6% and 66.7% in patients who underwent observation only vs chest tube drainage. The respective hospital mortality rates were 13.3% and 38.0%. The total pneumothorax recurrence rate after hospital discharge was 34.6% (n = 9).ConclusionsPneumothorax in patients with IPF was difficult to treat successfully, had a relatively poor prognosis, and showed a high recurrence rate.
Highlights
Some patients with idiopathic pulmonary fibrosis (IPF) develop pneumothorax
Patients We retrospectively reviewed the clinical records of all patients with IPF who were first admitted for pneumothorax to the Kindai University Hospital from January 2008 to December 2019
Data collection We recorded the clinical characteristics of all the study patients, which included the following: findings on physical examination, standard laboratory tests performed on admission, use of long-term oxygen therapy (LTOT), and treatments for IPF
Summary
Some patients with idiopathic pulmonary fibrosis (IPF) develop pneumothorax. The characteristics of pneumothorax in patients with IPF have not been elucidated. The purpose of this study was to clarify the clinical course, actual management, and treatment outcomes of pneumothorax in patients with IPF. Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive and fibrosing lung disease of unknown etiology [1]. Many patients with IPF undergo acute respiratory events such as acute exacerbation (AE), pulmonary infection, pulmonary edema due to heart failure, pulmonary embolism, mediastinal emphysema, and pneumothorax [3,4,5,6]. The rates of pneumothorax reportedly range from 2 to 20% in patients with IPF, which is second highest to the rates occurring in patients with chronic obstructive pulmonary disease (COPD) [7,8,9,10,11].
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