Acil Servise Başvuran Pnömotoraks Hastalarında EKG Değerlendirilmesi: Üç Yıllık Bir Analiz

Abstract

Amaç: Pnömotoraks, nefes darlığı ve göğüs ağrısı ile acil servise başvuran hastaların hayatı tehdit eden ayırıcı tanılarından biridir. Dinamik elektrokardiyografi (EKG) değişikliklerinin pnömotoraks tanısındaki yeri iyi tanımlanmamıştır. Çalışmamızın amacı, pnömotoraksta EKG'nin klinik önemini ortaya çıkarmaktır. Gereç ve Yöntem: 01.04.2014 – 01.04.2017 tarihleri arasında acil servisimize başvuran ve pnömotoraks tanısı alan 147 hasta geriye dönük olarak incelendi. Hastalar Grup 1 (pnömotoraks hacmi <% 20) ve grup 2 (pnömotoraks hacmi>% 20) olarak ayrıldı. Hasta demografik özellikleri, pnömotoraks oluşum mekanizması (travmatik veya spontan), Röntgen ve tomografi bulguları, EKG bulguları, hastanede yatış-takip süreleri, tedavi yöntemleri; hastanenin veri kayıt sisteminden elde edildi ve gruplar arasında karşılaştırıldı. Bulgular: 147 hastanın 109'unda (% 74,1) travmatik pnömotoraks, 38'inde (% 25,8) spontan pnömotoraks vardı (p <0,001). Spontan pnömotoraks vakalarından 21'i (% 55,2) birincil spontan pnömotoraks (PSP) idi. Hastaların% 64.6'sında (n = 95) göğüs ağrısı vardı. İki hasta grubu yaş, hemoglobin düzeyi, GKS, takip edilen gün sayısı, cinsiyet ve sigara içme durumu açısından birbirinden farklı değildi (p> 0.05). EKG verileri incelendiğinde iki grup arasında fark bulundu; Grup 1'deki hastaların% 52,8'inde EKG değişiklikleri varken, grup-2'deki tüm hastaların (% 100) olağandışı EKG bulguları vardı (p = 0,004). Sonuç: Pnömotoraks acil serviste gözden kaçırılmaması gereken bir durumdur. EKG'sinde anormal bulgular olan durumlarda pnömotoraks (Klinik olarak anlamlı pnömotoraks, boyut>% 20) hatırlanmalıdır.

Keywords

• elektrokardiyografi
• spontan pnömotoraks
• travmatik pnömotoraks

ECG Evaluation in Patients with Pneumothorax Admitted to the Emergency Department: A Three years Analysis

Abstract

Objective: Pneumothorax is one of the life-threatening differential diagnoses of patients presenting to emergency department (ED) with shortness of breath and chest pain. The place of dynamic electrocardiography (ECG) changes in diagnosis of pneumothorax was not well defined. The aim of our study was to reveal the clinical importance of ECG in pneumothorax. Methods: Between 01.04.2014 and 01.04.2017, 147 patients who applied to our ED and take a diagnosis of pneumothorax were retrospectively examined. The patients were divided as Group 1 (with pneumothorax volume <20%), and group 2 (with pneumothorax volume> 20%). Patient demographics, mechanism of pneumothorax formation (traumatic or spontaneous), X ray and tomographic findings, ECG findings, hospitalization-follow-up periods, treatment methods; were derived from the hospital's data recording system and compared between groups. Results: 109 (74.1 %) of 147 patients had a traumatic pneumothorax, and 38 (25.8%) had a spontaneous pneumothorax (p <0.001). 21 (55.2%) of the spontaneous pneumothorax cases are primary spontaneous pneumothorax. 64.6% (n=95) of the patients had chest pain. The two groups were similar in terms of age, hemoglobin level, GCS, number of days followed, gender and smoking status, (p> 0.05). When the ECG data was analyzed, a difference was found between the two groups. While 52.8% of the patients in group 1 had ECG changes, all of the patients in group-2 (100%) had unusual ECG findings (p = 0.004). Conclusion: Pneumothorax is a condition that should not be overlooked at ED. Pneumothorax especially with large volume size (size> 20%) should be remembered in cases with abnormal findings in their ECG.

Keywords

• electrocardiography
• spontaneous pneumothorax
• traumatic pneumothorax

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