RESUMO
Guidelines on spontaneous pneumothorax are contradictory as to intervention between needle aspiration (NA) and chest tube drainage (CTD). Studies show poor adherence to guidelines.Three Norwegian hospitals included patients with primary (PSP) and secondary (SSP) spontaneous pneumothorax. Patients underwent NA or CTD as the primary intervention. The main outcome was duration of hospital stay. Secondary outcomes were immediate- and 1-week success rates and complications.127 patients were included, including 48 patients with SSP. 65 patients underwent NA, 63 patients CTD. Median (interquartile range) hospital stay was significantly shorter for NA: 2.4 days (1.2-4.7 days), compared with CTD: 4.6 days (2.3-7.8 days) (p<0.001). The corresponding figures for the SSP subgroup were 2.54 days (1.17-7.79 days) compared with 5.53 days (3.65-9.21 days) (p=0.049) for NA and CTD, respectively. Immediate success rates were 69% for NA compared with 32% for CTD (p<0.001). The positive effect of NA remained significant in sub-analyses for SSP. There was no significant difference in 1-week success rates. Complications occurred only during the CTD-treatment.Our study shows shorter hospital stay and higher immediate success rates for NA compared with CTD. Subgroup analyses also show clear benefits for NA for both PSP and SSP.
Assuntos
Drenagem , Pneumotórax/cirurgia , Complicações Pós-Operatórias/epidemiologia , Sucção/métodos , Adulto , Tubos Torácicos , Feminino , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Agulhas , Noruega , Adulto JovemAssuntos
Ética Institucional , Hospitais de Distrito/normas , Televisão , Confidencialidade , Humanos , Legislação Médica , NoruegaRESUMO
We conducted a survey of alcohol and drug habits among patients hospitalized in our department during a six month period. Alcohol and drug abuse was found among 185 (11%) of the patients, with a male-to-female ratio of 2.3. The median age was 52 years for women and 53 for men. Generally, the levels of education and employment were low among the alcohol and drug abusing patients. In contrast to our experience, most general practitioners in our catchment area considered alcohol and drug abuse as a minor problem in their patients. During the last 25 years only seven of 54 medical clinics in Norway have performed a systematic registration of alcohol and drug habits among their patients. Patients with alcohol and drug abuse constituted a marked proportion of hospitalized patients in our clinic, and they consumed a substantial portion of our resources.
