management of pneumothorax in emergency medicine departments: multicenter trial

background: pneumothorax is common and life-threatening clinical condition which may require emergency treatment in emergency medicine departments. objectives: we aimed to reveal the epidemiological analysis of the patients admitted to the emergency department with pneumothorax. material and methods: this case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. patient data were collected from hospital automation system. according to the etiology of the pneumothorax, study groups were arranged like spontaneous pneumothorax and traumatic pneumothorax. results: 82.2% (n = 106) of patients were male and 17.8% (n = 23) of patients were female and mean age were 31.3 ± 20,2 (minimum: 1, maximum: 87). 68.2% (n = 88) of patients were spontaneous pneumothorax (61.36%, n=79 were primary spontaneous pneumothorax) and 31.8% (n = 41) of patients were traumatic pneumothorax (21.95% were iatrogenic pneumothorax). main complaint is shortness of breath (52.3%, n=67) and 38% (n=49) of patients were smokers. posteroanterior (pa) chest x-ray has been enough for 64.3% (n = 83) of the patients' diagnosis. tube thoracostomy is applied to 84.5% (n = 109) of patients and surgery is applied to 9.3% (n = 12) of patients and 6.2% (n = 8) of patients were discharged with conservative treatment. spontaneous pneumothorax showed statistically significant high recurrence compared with traumatic pneumothorax (p = 0.007). 4.65% of (n = 6) patients died. the average age of those who died (9.3 ± 19.9), statistically were significantly lower the mean age of living patients (32.4 ± 19.7) (t test, p = 0,006). 83.33% of the patients who died were neonatals and in the 0-1 years age group, and five of these patients were secondary spontaneous pneumothorax, and one of these patients were iatrogenic pneumothorax due to mechanical ventilation. conclusions: pneumothorax in adults can be treated by tube thoracostomy or surgically. despite treatment, mortality of secondary and iatrogenic pneumothorax in newborns and 0-1 years age group is high.