Pneumomediastinum epidemiology and demographics
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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 2.25/100,000 of accident and emergency admissions[1].
- Pneumomediastinum has incidence of 1 per 100,000 natural births, being more frequent in children (6-125/100,000).
Prevalence
- Spontaneous pneumomediastinum is more common in young men and pregnant women.
- 4 cases out of 100,000 of the general population were between the ages of 5 and 34 years, with the predominance being young adult men[2][3].
- The prevalence of spontaneous pneumomediastinum is reported between 2.3 to 125 in 100,000 individual.[4].
- In a retrospective study reported a prevalence of 0.3% in children presenting in the emergency room with underlying asthma and acute exacerbation. Mean age was 11.8 years with a male:female ratio of 1.15:1[5].
- 70% of cases of pneumomediastinum in children are due to exacerbation of asthma or respiratory tract infection.
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.
- 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[6].
- Pneumomediastinum was associated with higher mortality (9 [12.5%] vs 118 [3.6%] patients; P < .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 PNM 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.
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.
Developed Countries
Developing Countries
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.
- ↑ Stack AM, Caputo GL (April 1996). "Pneumomediastinum in childhood asthma". Pediatr Emerg Care. 12 (2): 98–101. PMID 8859917.
- ↑ 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.
- ↑ "Pneumomediastino espontâneo: Asma".