Pneumomediastinum epidemiology and demographics: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence=== | ===Incidence=== | ||
*The pneumomediastinum is a rare entity, diagnosed in 2.25 | *The pneumomediastinum is a rare entity, diagnosed in 2.25 per 100,000 of accident and emergency admissions.<ref name="pmid23017291">{{cite journal |vauthors=Russo A, Del Vecchio C, Zaottini A, Giangregorio C |title=Role of emergency thoracic ultrasonography in spontaneous pneumomediastinum. Two case report |journal=G Chir |volume=33 |issue=8-9 |pages=285–96 |date=2012 |pmid=23017291 |doi= |url=}}</ref> | ||
*Pneumomediastinum has incidence of 1 per 100,000 natural births, being more frequent in children (6-125 | *Pneumomediastinum has an incidence of 1 per 100,000 natural births, being more frequent in children (6-125 per 100,000 individuals). | ||
*The incidence of pneumomediastinum in age group 5 and 34 years is 4 cases per 100,000 individuals of general population, predominantly young men.<ref name="pmid16835735">{{cite journal |vauthors=Oertel MF, Korinth MC, Reinges MH, Krings T, Terbeck S, Gilsbach JM |title=Pathogenesis, diagnosis and management of pneumorrhachis |journal=Eur Spine J |volume=15 Suppl 5 |issue= |pages=636–43 |date=October 2006 |pmid=16835735 |pmc=1602196 |doi=10.1007/s00586-006-0160-6 |url=}}</ref><ref name="pmid16304275">{{cite journal |vauthors=Newcomb AE, Clarke CP |title=Spontaneous pneumomediastinum: a benign curiosity or a significant problem? |journal=Chest |volume=128 |issue=5 |pages=3298–302 |date=November 2005 |pmid=16304275 |doi=10.1378/chest.128.5.3298 |url=}}</ref> | |||
*The incidence of spontaneous pneumomediastinum is reported between 2.3 to 125 per 100,000 individuals.<ref name="pmid11180677">{{cite journal |vauthors=Chalumeau M, Le Clainche L, Sayeg N, Sannier N, Michel JL, Marianowski R, Jouvet P, Scheinmann P, de Blic J |title=Spontaneous pneumomediastinum in children |journal=Pediatr. Pulmonol. |volume=31 |issue=1 |pages=67–75 |date=January 2001 |pmid=11180677 |doi= |url=}}</ref> | |||
* | |||
*The | |||
===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 rate|mortality]] rates. | *Pneumomediastinum is a clinical condition with potential complications that can cause high [[morbidity]] and [[Mortality rate|mortality]] rates. | ||
*A [[Retrospective|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 rate|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 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). | **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 [[Mediastinum|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=== | ||
| Line 29: | Line 25: | ||
*Infants have high incidence rates of 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=== | ||
| Line 35: | Line 33: | ||
===Gender=== | ===Gender=== | ||
*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> | *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> | ||
===Region=== | ===Region=== | ||
Geographical location has no effect on epidemiology of pneumomediastinum. | Geographical location has no effect on epidemiology of pneumomediastinum. | ||
==References== | ==References== | ||
Revision as of 15:45, 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 in 2.25 per 100,000 of accident and emergency admissions.[1]
- Pneumomediastinum has an incidence of 1 per 100,000 natural births, being more frequent in children (6-125 per 100,000 individuals).
- The incidence of pneumomediastinum in age group 5 and 34 years is 4 cases per 100,000 individuals of general population, predominantly young men.[2][3]
- The incidence of spontaneous pneumomediastinum is reported between 2.3 to 125 per 100,000 individuals.[4]
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.[5]
- 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.[6]
- 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
- Males are more commonly affected by pneumomediastinum than females. The male to female ratio is approximately 8:1.[7]
Region
Geographical location has no effect on epidemiology of pneumomediastinum.
References
- ↑ Russo A, Del Vecchio C, Zaottini A, Giangregorio C (2012). "Role of emergency thoracic ultrasonography in spontaneous pneumomediastinum. Two case report". G Chir. 33 (8–9): 285–96. PMID 23017291.
- ↑ Oertel MF, Korinth MC, Reinges MH, Krings T, Terbeck S, Gilsbach JM (October 2006). "Pathogenesis, diagnosis and management of pneumorrhachis". Eur Spine J. 15 Suppl 5: 636–43. doi:10.1007/s00586-006-0160-6. PMC 1602196. PMID 16835735.
- ↑ Newcomb AE, Clarke CP (November 2005). "Spontaneous pneumomediastinum: a benign curiosity or a significant problem?". Chest. 128 (5): 3298–302. doi:10.1378/chest.128.5.3298. PMID 16304275.
- ↑ Chalumeau M, Le Clainche L, Sayeg N, Sannier N, Michel JL, Marianowski R, Jouvet P, Scheinmann P, de Blic J (January 2001). "Spontaneous pneumomediastinum in children". Pediatr. Pulmonol. 31 (1): 67–75. PMID 11180677.
- ↑ 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".