2Department of Thoracic Surgery, Izmir Bakircay University, Cigli Training and Research Hospital, Izmir, Turkey DOI : 10.26663/cts.2024.016 Viewed : 63 - Downloaded : 23 Background: Results of studies to predict prolonged air leak (PAL) after chest tube administration in primary spontaneous pneumothorax (PSP) have been inconsistent and have limited use. In this study, in which we used a scale grading the amount of air leak, we investigated the correlation between the scale and the duration of air leak and its potential to be a predictor of PAL.
Materials and Methods: PSP cases (n = 140) requiring chest tube insertion between April 2017 and December 2021 were prospectively studied. We graded the air leak in these patients using a 5-grade scale. We designed eight 'SUM' variants using air leak grades within the first five days after chest tube administration. In this study, PAL was defined as an air leak lasting more than five days.
Results: Total PAL occurrence was 29 (20.7%) in this cohort with a mean age of 26.6±8.14 years. Correlation analyses showed that each SUM variable correlated highly with the duration of the air leak, and SUM7to8, the sum of two consecutive values of air leak grades on the fourth day, was proved to be the most powerful predictor. When SUM7to8 ≥ 1, PAL can be predicted with a positive and negative predictive value of 69% and 100%, respectively. The sensitivity and specificity are 100% and 88.3%, respectively.
Conclusions: This simple new method of predicting PAL using SUM7to8 has shown that the amount of air leak is a powerful independent predictor of PAL. Therefore, grading air leakage in PSP is a useful method to predict PAL.
Keywords : prolonged air leak, primary spontaneous pneumothorax, air leak grade, chest tubes