Factors Associated to the Presence of Pneumothorax in Cystic Fibrosis Patients in the City of Madrid
Author(s)
Prados Concepción*,
Carpio Carlos,
Martínez María Teresa,
Máiz Luis,
Girón Rosa,
Barrio Isabel,
Salcedo Antonio,
García Hernández Gloria,
Gómez Carrera Luis,
Álvarez-Sala Rodolfo
Affiliation(s)
Prados Sánchez, Concepción, Department of Pneumology, La Paz University Hospital, Madrid.
Prados Sánchez, Concepción, Department of Pneumology, La Paz University Hospital, Madrid.
ABSTRACT
Background: To identify risk factors associated with pneumothorax and to determine the prognosis of cystic fibrosis patients following an episode of pneumothorax in the city of Madrid. Methods: Records of 17 patients (10 males; age 24.4 ± 17.5 years) and 32 controls, and a total of 44 pneumothorax episodes were studied. We have analyzed the characteristics of the pneumothorax, the microbiology, the lung function tests (LFT) and the prognosis of patients. Two controls with cystic fibrosis and without pneumothorax matched for sex and age were selected. Results: Eight male and three female patients with pneumothorax were older than 18 years. The mean age of the first pneumothorax episode was 18.3 years (±9.6). The group with pneumothorax had a mean body mass index of 19.2(±2.42 kg/m2) and in the control group it was 26.5 (±1.98 kg/m2). Pseudomonas aeruginosa was present in fourteen patients (82%) with pneumothorax and in eleven patients (34.4%) in the control group (p = 0.002). Pneumothorax predominantly occurred in the coldest seasons. There was a significant drop in both forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) after the pneumothorax. In the same way, FEV1 and FVC were greater in the control group. Six patients (35.4%) with pneumothorax and two patients in the control group have died (p < 0.05). Conclusions: Patients with pneumothorax are more likely to have P. aeruginosa colonization. LFT drop after an episode of pneumohorax. Patients with pneumothorax have worse LFT than patients without pneumothorax. Mortality is greater in patients with pneumothorax.
Background: To identify risk factors associated with pneumothorax and to determine the prognosis of cystic fibrosis patients following an episode of pneumothorax in the city of Madrid. Methods: Records of 17 patients (10 males; age 24.4 ± 17.5 years) and 32 controls, and a total of 44 pneumothorax episodes were studied. We have analyzed the characteristics of the pneumothorax, the microbiology, the lung function tests (LFT) and the prognosis of patients. Two controls with cystic fibrosis and without pneumothorax matched for sex and age were selected. Results: Eight male and three female patients with pneumothorax were older than 18 years. The mean age of the first pneumothorax episode was 18.3 years (±9.6). The group with pneumothorax had a mean body mass index of 19.2(±2.42 kg/m2) and in the control group it was 26.5 (±1.98 kg/m2). Pseudomonas aeruginosa was present in fourteen patients (82%) with pneumothorax and in eleven patients (34.4%) in the control group (p = 0.002). Pneumothorax predominantly occurred in the coldest seasons. There was a significant drop in both forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) after the pneumothorax. In the same way, FEV1 and FVC were greater in the control group. Six patients (35.4%) with pneumothorax and two patients in the control group have died (p < 0.05). Conclusions: Patients with pneumothorax are more likely to have P. aeruginosa colonization. LFT drop after an episode of pneumohorax. Patients with pneumothorax have worse LFT than patients without pneumothorax. Mortality is greater in patients with pneumothorax.
Cite this paper
nullP. Concepción, C. Carlos, M. Teresa, M. Luis, G. Rosa, B. Isabel, S. Antonio, G. Gloria, G. Luis and Á. Rodolfo, "Factors Associated to the Presence of Pneumothorax in Cystic Fibrosis Patients in the City of Madrid," International Journal of Clinical Medicine, Vol. 2 No. 3, 2011, pp. 212-217. doi: 10.4236/ijcm.2011.23035.
nullP. Concepción, C. Carlos, M. Teresa, M. Luis, G. Rosa, B. Isabel, S. Antonio, G. Gloria, G. Luis and Á. Rodolfo, "Factors Associated to the Presence of Pneumothorax in Cystic Fibrosis Patients in the City of Madrid," International Journal of Clinical Medicine, Vol. 2 No. 3, 2011, pp. 212-217. doi: 10.4236/ijcm.2011.23035.
References
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Cystic fibrosis foundation consensus conference report on pulmonary complications of cystic fibrosis. Pediatr Pulmonol 1993; 15: 187-98. [33] Flume PA, Mogayzel PJ Jr, Robinson KA, Rosenblatt RL, Quittell L, Marshall BC. Clinical Practice Guidelines for Pulmonary Therapies Committee. Cystic fibrosis pulmonary guidelines: pulmonary complications: hemoptysis and pneumothorax. Am J Respir Crit Care Med 2010; 182: 298-306. [34] Flume PA. Pulmonary complications of cystic fibrosis. Respir Care 2009; 54: 618-27.
[1] Collins FS. Cystic fibrosis: molecular biology and therapeutic implications. Science 1992; 256: 74-9. [2] Máiz L, Baranda F, Coll R, Prados C, Vendrell M, Escribano A, et al. Guideline for diagnosis and treatment of respiratory involvements in cystic fibrosis. Arch Bronconeumol 2001; 37: 316-24. [3] Flume PA, Strange C, Ye X, Ebeling M, Hulsey T, Clark LL. Pneumothorax in cystic fibrosis. Chest 2005; 128: 720-8. [4] Flume PA. Pneumothorax in Cystic Fibrosis. Chest 2003; 123: 217-21. [5] Schramel FM, Postmus PE, Vanderschueren RG. Current aspects of spontaneous pneumothorax. Eur Respir J 1997; 10: 1372-9. [6] Spector ML, Stern RC. Pneumothorax in cystic fibrosis: a 26-year experience. Ann Thorac SurG 1989; 47: 204-7. [7] Yankaskas JR, Marshall BC, Sufian B, Simon RH, Rodman D. Cystic fibrosis adult care: consensus conference report. Chest 2004; 125(suppl 1): 1-39. [8] Dodge J. A, Lewis P.A, Stanton M, Wilsher J. Cystic fibrosis mortality and survival in the UK: 1947–2003. Eur Respir J 2007; 29: 522-6. [9] MacDuff A, Tweedie J, McIntosh L, Innes JA. Pneumothorax in cystic fibrosis: prevalences and outcome in Scotland. J Cyst Fib 2010; 9: 246-9. [10] Simmonds NJ, Macneill SJ, Cullinan P, Hodson M. Cystic fibrosis and survival to 40 years: a case-control study [abstract]. Eur Respir J. Published Online First: 8 April 2010. doi:10.1183/09031936.00001710 [11] Hafen GM, Ukoumunne OC, Robinson PJ. Pneumothorax in cystic fibrosis: a retrospective case series. Arch Dis Child 2006; 91: 924-5. [12] Martínez MT. Complicaciones pulmonares no infecciosas en la fibrosis quística del adulto. Arch Bronconeumol 1998; 34: 400-4. [13] FitzSimmons SC. The changing epidemiology of cystic fibrosis. J Pediatr 1993; 122: 1-9. [14] Stenbit A, Flume PA. Pulmonary complications in adult patients with cystic fibrosis. Am J Med Sci 2008; 335: 55-9. [15] Liou TG, Woo MS, Cahill BC. Lung transplantation for cystic fibrosis. Curr Opin Pulm Med 2006; 12: 459-63. [16] Schidlow DV, Taussig LM, Knowles MR. Cystic fibrosis foundation consensus conference report on pulmonary complications of cystic fibrosis. Pediatr Pulmonol 1993; 15: 187-98. [17] Graf-Deuel E, Knoblauch A. Simultaneous bilateral spontaneous pneumothorax. Chest 1994; 105: 1142-6. [18] Bulajich B, Subotich D, Mandarich D, Kljajich RV, Gajich M. Influence of atmospheric pressure, outdoor temperature, and weather phases on the onset of spontaneous pneumothorax. Ann Epidemiol 2005; 15: 185-90. [19] Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachanet D. Epidemiology of pneumothorax in England. Thorax 2000; 55: 666-71. [20] Garske LA, Tam R, Windsor MF, Bell S. Novel application of biological glue in the management of a complicated pneumothorax in cystic fibrosis. Pediatr Pulmonol 2002; 34: 138-40. [21] Farrel PM, Kosorol MR, Rock MJ, Laxova A, Zeng L, Lai HC, et al. Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Pediatrics 2001; 107: 1-13. [22] Gaskin K, Gurwittz D, Durie P, Corey M, Levison H, Forstner G. Improved prognosis in patients with cystic fibrosis with normal fat absorption. J Pediatr 1982; 100: 857-62. [23] Prados C, Máiz L, Antelo C, Baranda H, Blázquez J, Borro JM, et al. Cystic fibrosis: consensus on the treatment of pneumothorax and massive hemoptysis and on the indications for lung transplantation. Arch Bronconeumol 2000; 36: 411-6. [24] Penketh AR, Knight RK, Hodson ME, Batten JC. Management of pneumothorax in adults with cystic fibrosis. Thorax 1982; 37: 850-3. [25] Noppen M, Dhondt E, Mahler T, Malfroot A, Dab I, Vincken W. Successful management of recurrent pneumothorax in cystic fibrosis by localized apical thoracoscopic talc poudrage. Chest 1994; 106: 262-4. [26] Amin R, Noone PG, Ratjen F. Chemical pleurodesis versus surgical intervention for persistent and recurrent pneumothoraces in cystic fibrosis. Cochrane Database Syst Rev 2009; 2: CD007481. [27] Fiel S. Clinical management of pulmonary disease in cystic fibrosis. Lancet 1993; 341: 1070-4. [28] Seddon DJ, Hodson ME. Surgical management of pneumothorax in cystic fibrosis. Thorax 1988; 43: 739-40. [29] Curtis HJ, Bourke SJ, Dark JH, Corris PA. Lung transplantation outcome in cystic fibrosis patients with previous pneumothorax. J Heart Lung Transplant 2005; 24: 865-9. [30] Hazelrigg SR, Landrenean RJ, Mack M, Acuff T, Seifert PE, Auer JE, et al. Thoracoscopic stapled resection for spontaneus pneumothorax. J Thorac Cardiovasc Surg 1993; 105: 392-3. [31] Wakabayashi A, Brenner N, Wilson A, Tadir Y, Berns W. Thoracoscopic treatment of spontaneus pneumothorax using carbon dioxide laser. Ann Thorac Surg 1990; 50: 786-90. [32] Schidlow DV, Tausing LM, Knowles MR. Cystic fibrosis foundation consensus conference report on pulmonary complications of cystic fibrosis. Pediatr Pulmonol 1993; 15: 187-98. [33] Flume PA, Mogayzel PJ Jr, Robinson KA, Rosenblatt RL, Quittell L, Marshall BC. Clinical Practice Guidelines for Pulmonary Therapies Committee. Cystic fibrosis pulmonary guidelines: pulmonary complications: hemoptysis and pneumothorax. Am J Respir Crit Care Med 2010; 182: 298-306. [34] Flume PA. Pulmonary complications of cystic fibrosis. Respir Care 2009; 54: 618-27.