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 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".