Pneumomediastinum epidemiology and demographics: Difference between revisions
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{{CMG}}; {{AE}} {{Trusha}} | {{CMG}}; {{AE}} {{Trusha}} | ||
==Overview== | ==Overview== | ||
Pneumomediastinum is a rare condition. Epidemiology of pneumomediastinum reflects the epidemiology of diseases associated with the condition. | Pneumomediastinum is a rare condition. [[Epidemiology]] of pneumomediastinum reflects the epidemiology of diseases associated with the condition. | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence=== | ===Incidence=== | ||
* | *The pneumomediastinum is a rare entity, diagnosed approximately 2.25 per 100,000 of accident and emergency admissions.<ref>{{cite journal|doi=10.3978/j.issn.2072-1439.2015.01.11}}</ref><ref name="MaciaMoya2007">{{cite journal|last1=Macia|first1=I|last2=Moya|first2=J|last3=Ramos|first3=R|last4=Morera|first4=R|last5=Escobar|first5=I|last6=Saumench|first6=J|last7=Perna|first7=V|last8=Rivas|first8=F|title=Spontaneous pneumomediastinum: 41 cases|journal=European Journal of Cardio-Thoracic Surgery|volume=31|issue=6|year=2007|pages=1110–1114|issn=10107940|doi=10.1016/j.ejcts.2007.03.008}}</ref> | ||
*Pneumomediastinum has an incidence of 1 per 100,000 natural births, being more frequent in children (6-125 per 100,000 individuals). | |||
<ref | |||
* | |||
===Case-fatality rate/Mortality rate=== | ===Case-fatality rate/Mortality rate=== | ||
*Pneumomediastinum is a clinical condition with potential complications that can cause high morbidity and mortality rates. | *Pneumomediastinum is a clinical condition with potential complications that can cause high [[morbidity]] and [[Mortality rate|mortality]] rates. | ||
*A retrospective review of medical records from January 1, 2002, to December 31, 2011, was conducted at a university-based urban trauma center. | *A [[Retrospective|retrospective review]] of medical records from January 1, 2002, to December 31, 2011, was conducted at a university-based urban trauma center.<ref name="LeeChong2015">{{cite journal|last1=Lee|first1=Wayne S.|last2=Chong|first2=Vincent E.|last3=Victorino|first3=Gregory P.|title=Computed Tomographic Findings and Mortality in Patients With Pneumomediastinum From Blunt Trauma|journal=JAMA Surgery|volume=150|issue=8|year=2015|pages=757|issn=2168-6254|doi=10.1001/jamasurg.2015.1138}}</ref> | ||
**According to the study, 72 patients out of 3327 (2.2%) patients with [[blunt trauma]] had pneumomediastinum. | |||
*Pneumomediastinum was associated with higher mortality (9 [12.5%] vs 118 [3.6%] patients; P < | **Patients with pneumomediastinum had higher Injury Severity (ISS) Scores (P < 0.001) and chest Abbreviated Injury Scale (AIS) scores (P < 0.001) compared with those without pneumomediastinum. | ||
*According to the study | **Pneumomediastinum was associated with higher [[Mortality rate|mortality]] (9 [12.5%] vs 118 [3.6%] patients; P < 0.001) and longer mean (SD) hospital stays (11.3 [14.6] vs 5.1 [8.8] days; P < 0.001), intensive care unit stays (5.4 [10.2] vs 1.8 [5.7] days; P < 0.001), and [[Medical ventilator|ventilator]] days (1.7 [4.2] vs 0.6 [4.0] days; P < 0.03). | ||
*Air in all mediastinal compartments was also associated with increased mortality of 40.0% (4 of 10 patients; P = 0.01). Presence of hemothorax along with | **According to the study pneumomediastinum size was not associated with in-hospital [[Mortality rate|mortality]] (P = 0.22). However, the location of air in the [[posterior mediastinum]] was associated with increased [[Mortality rate|mortality]] of 25% (7 of 28 patients; P = 0.007). | ||
**Air in all [[Mediastinum|mediastinal compartments]] was also associated with increased mortality of 40.0% (4 of 10 patients; P = 0.01). Presence of [[hemothorax]] along with pneumomediastinum was associated with mortality of 22.2% (8 of 36 patients; P = 0.01). | |||
===Age=== | ===Age=== | ||
*Patients of all age groups may develop pneumomediastinum. | *Patients of all age groups may develop pneumomediastinum. | ||
*Infants have high incidence rates of pneumomediastinum. | |||
*The incidence of pneumomediastinum is high in the general population between the ages of 5 and 34 years, with the predominance being young adult men and pregnant women. | *The incidence of pneumomediastinum is high in the general population between the ages of 5 and 34 years, with the predominance being young adult men and pregnant women. | ||
*In a [[Retrospective cohort study|retrospective study]], a prevalence of 30 per 100,000 children presenting in the emergency room with underlying asthma and acute exacerbation was reported. Mean age was 11.8 years with a male:female ratio of 1.15:1.<ref name="pmid8859917">{{cite journal |vauthors=Stack AM, Caputo GL |title=Pneumomediastinum in childhood asthma |journal=Pediatr Emerg Care |volume=12 |issue=2 |pages=98–101 |date=April 1996 |pmid=8859917 |doi= |url=}}</ref> | |||
*70% of cases of pneumomediastinum in children are due to [[Asthma exacerbation resident survival guide|exacerbation of asthma]] or [[respiratory tract infection]]. | |||
===Race=== | ===Race=== | ||
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===Gender=== | ===Gender=== | ||
* | *Adult males are more commonly affected by pneumomediastinum than females. The male to female ratio is approximately 8:1.<ref name="urlPneumomediastino espontâneo: Asma">{{cite web |url=http://www.scielo.mec.pt/scielo.php?pid=S0873-21592008000300011&script=sci_arttext&tlng=es |title=Pneumomediastino espontâneo: Asma |format= |work= |accessdate=}}</ref> | ||
*In children male:female ratio is 1.15:1. | |||
===Region=== | ===Region=== | ||
Geographical location has no effect on epidemiology of pneumomediastinum. | |||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: | [[Category:Pulmonology]] | ||
[[Category:Medicine]] | |||
[[Category:Surgery]] | |||
[[Category:Cardiology]] | |||
[[Category:Emergency medicine]] | |||
Latest revision as of 20:06, 17 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
Pneumomediastinum is a rare condition. Epidemiology of pneumomediastinum reflects the epidemiology of diseases associated with the condition.
Epidemiology and Demographics
Incidence
- The pneumomediastinum is a rare entity, diagnosed approximately 2.25 per 100,000 of accident and emergency admissions.[1][2]
- Pneumomediastinum has an incidence of 1 per 100,000 natural births, being more frequent in children (6-125 per 100,000 individuals).
Case-fatality rate/Mortality rate
- Pneumomediastinum is a clinical condition with potential complications that can cause high morbidity and mortality rates.
- A retrospective review of medical records from January 1, 2002, to December 31, 2011, was conducted at a university-based urban trauma center.[3]
- According to the study, 72 patients out of 3327 (2.2%) patients with blunt trauma had pneumomediastinum.
- Patients with pneumomediastinum had higher Injury Severity (ISS) Scores (P < 0.001) and chest Abbreviated Injury Scale (AIS) scores (P < 0.001) compared with those without pneumomediastinum.
- Pneumomediastinum was associated with higher mortality (9 [12.5%] vs 118 [3.6%] patients; P < 0.001) and longer mean (SD) hospital stays (11.3 [14.6] vs 5.1 [8.8] days; P < 0.001), intensive care unit stays (5.4 [10.2] vs 1.8 [5.7] days; P < 0.001), and ventilator days (1.7 [4.2] vs 0.6 [4.0] days; P < 0.03).
- According to the study pneumomediastinum size was not associated with in-hospital mortality (P = 0.22). However, the location of air in the posterior mediastinum was associated with increased mortality of 25% (7 of 28 patients; P = 0.007).
- Air in all mediastinal compartments was also associated with increased mortality of 40.0% (4 of 10 patients; P = 0.01). Presence of hemothorax along with pneumomediastinum was associated with mortality of 22.2% (8 of 36 patients; P = 0.01).
Age
- Patients of all age groups may develop pneumomediastinum.
- Infants have high incidence rates of pneumomediastinum.
- The incidence of pneumomediastinum is high in the general population between the ages of 5 and 34 years, with the predominance being young adult men and pregnant women.
- In a retrospective study, a prevalence of 30 per 100,000 children presenting in the emergency room with underlying asthma and acute exacerbation was reported. Mean age was 11.8 years with a male:female ratio of 1.15:1.[4]
- 70% of cases of pneumomediastinum in children are due to exacerbation of asthma or respiratory tract infection.
Race
- There is no racial predilection to pneumomediastinum.
Gender
- Adult males are more commonly affected by pneumomediastinum than females. The male to female ratio is approximately 8:1.[5]
- In children male:female ratio is 1.15:1.
Region
Geographical location has no effect on epidemiology of pneumomediastinum.
References
- ↑ . doi:10.3978/j.issn.2072-1439.2015.01.11. Missing or empty
|title=(help) - ↑ Macia, I; Moya, J; Ramos, R; Morera, R; Escobar, I; Saumench, J; Perna, V; Rivas, F (2007). "Spontaneous pneumomediastinum: 41 cases". European Journal of Cardio-Thoracic Surgery. 31 (6): 1110–1114. doi:10.1016/j.ejcts.2007.03.008. ISSN 1010-7940.
- ↑ Lee, Wayne S.; Chong, Vincent E.; Victorino, Gregory P. (2015). "Computed Tomographic Findings and Mortality in Patients With Pneumomediastinum From Blunt Trauma". JAMA Surgery. 150 (8): 757. doi:10.1001/jamasurg.2015.1138. ISSN 2168-6254.
- ↑ Stack AM, Caputo GL (April 1996). "Pneumomediastinum in childhood asthma". Pediatr Emerg Care. 12 (2): 98–101. PMID 8859917.
- ↑ "Pneumomediastino espontâneo: Asma".