Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2023; 11(27): 6415-6423
Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6415
Closed thoracic drainage in elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax: A retrospective study
Wei Wang, Dong-Ning Zhu, Shan-Shan Shao, Jun Bao
Wei Wang, Dong-Ning Zhu, Shan-Shan Shao, Jun Bao, Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, Huangshan 242700, Anhui Province, China
Author contributions: Wang W and Bao J contributed equally to this work; Wang W designed the study; Zhu DN and Shao SS contributed to the analysis of the manuscript; Wang W and Bao J involved in the data and writing of this article; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the People’s Hospital of Shexian.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Bao, MM, Chief Physician, Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, No. 12 Shezhou Avenue, Huangshan 242700, Anhui Province, China. junbao2068@163.com
Received: July 18, 2023
Peer-review started: July 18, 2023
First decision: August 4, 2023
Revised: August 10, 2023
Accepted: August 31, 2023
Article in press: August 31, 2023
Published online: September 26, 2023
Processing time: 64 Days and 7.9 Hours
Abstract
BACKGROUND

Chronic obstructive pulmonary disease (COPD) combined with spontaneous pneumothorax, is characterized by significant decline in lung function, and even cause cardiopulmonary failure and hypoxia.

AIM

To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters (IPC) in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous pneumothorax.

METHODS

Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March 2023. The clinical efficacy, complications, hospitalization duration, and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter. Univariate logistic regression was used to analyze the causes of catheter displacement.

RESULTS

According to our findings, there were significant differences in the IPC group’s clinical efficacy, catheter operation time, and lung recruitment time (P < 0.05). Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics, catheter abscission, catheter blockage, and subcutaneous emphysema in the IPC group (P < 0.05). Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse’s working years (less than three), Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (less than 15), lack of catheter suture fixation, and the proportion of catheters not fixed twice (P < 0.05).

CONCLUSION

Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax, indwelling thoracic catheters are more effective than the central venous catheter group. Patients’ catheter shedding is influenced by the primary nurse’s working years, APACHE II scores, and catheter fixation technique.

Keywords: Indwelling thoracic catheter; Central venous catheter; Chronic obstructive pulmonary disease; Pneumothorax; Catheter detached

Core Tip: To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters in managing closed thoracic drainage in patients diagnosed with chronic obstructive pulmonary disease with concomitant by spontaneous pneumothorax.