Neonatal Pneumothorax Cases Managed with Chest Tube: A ۵-Year Single-Center Experience

Background: This study aimed to retrospectively evaluate the demographic characteristics, risk factors, treatment outcomes, and factors affecting mortality in neonatal pneumothorax cases treated with chest tubes in a tertiary neonatal intensive care unit. Methods: Data from ۹۷ neonates diagnosed with neonatal pneumothorax and treated with chest tubes between January ۲۰۱۹ and October ۲۰۲۳ were analyzed in a retrospective cohort design. Patients' demographic characteristics, clinical findings, accompanying comorbidities, treatment processes, and outcomes were analyzed. Factors affecting mortality were determined using univariate and multiple logistic regression analyses. Results: Of the ۹۷ cases included in the study, ۷۲.۲% were male. The mean gestational age was ۳۳.۴ ± ۴.۶ weeks, and the mean birth weight was ۲۳۱۳ ± ۱۰۲۲ grams. A diagnosis of pneumothorax was made within the first three days of life in ۷۴.۲% of cases. Pneumothorax was most commonly located on the right side (۴۹.۵%), and the most common accompanying pathologies were respiratory distress syndrome (۳۳.۰%) and congenital pneumonia (۲۴.۷%). The overall mortality rate was ۳۷.۱%. In multiple logistic regression analysis, ۵th-minute Apgar score <۷ (adjusted OR: ۶.۶۴; ۹۵% CI: ۲.۰۷–۲۱.۲۸; p = ۰.۰۰۱), presence of bilateral pneumothorax (adjusted OR: ۴.۴۴; ۹۵% CI: ۱.۱۲–۱۷.۶۲; p = ۰.۰۳۴), and low birth weight (OR: ۸.۴۱ for ۱۵۰۰–۲۴۹۹ g; OR: ۹.۵۳ for <۱۵۰۰ g) were determined as independent mortality predictors. Conclusion: The findings of this five-year retrospective cohort study demonstrate that mortality is significantly high in neonatal pneumothorax cases treated with chest tubes. Low birth weight, low ۵th-minute Apgar score, and the presence of bilateral pneumothorax are strong and independent predictors of mortality. Close monitoring and early aggressive treatment approaches are essential to reduce mortality in newborns with these risk factors.

کلیدواژه ها:

Chest tube ، Mortality ، Neonatal pneumothorax ، Newborn ، Risk factors