Pneumothorax: Demographics, Treatment, and Nursing Care.

内容摘要

Pneumothorax is a clinically heterogeneous condition with a substantial nursing-care burden; yet, contemporary descriptive data that combine medical and nursing variables remain scarce in the Croatian setting. Our aim was to describe the demographic profile, treatment patterns, and nursing-care requirements of patients treated for pneumothorax at a single regional hospital. Moreover, we explored factors associated with chest drainage and with adverse nursing-sensitive outcomes. We conducted a retrospective, single-centre, cross-sectional analysis of adult and adolescent patients consecutively admitted due to pneumothorax to Varaždin General Hospital between 1 January 2019 and 31 December 2021. Sociodemographic, clinical, and nursing-care variables were extracted from the hospital information system and the electronic nursing documentation. Nursing diagnoses were classified using NANDA International (NANDA-I) terminology. Proportions are reported with 95% Wilson score confidence intervals. Bivariate associations between categorical variables were assessed using the Fisher exact test with Haldane-Anscombe-corrected odds ratios; the Kruskal-Wallis test with Bonferroni-corrected pairwise comparisons were used for continuous distributions. Independent associations with the chest drainage placement, prolonged length of stay (>14 days), and worsening of dependency category were assessed with L1-penalised logistic regression (α = 0.5), with 1000-iteration non-parametric bootstrap 95% CIs and p-values. Of 60 patients included, 39 (65.0%; 95% CI 52.4-75.8) were male and 33 (55.0%; 42.5-66.9) were aged 60 years or older. Spontaneous pneumothorax accounted for 27 cases (45.0%; 33.1-57.5), traumatic for 23 (38.3%; 27.1-51.0), and iatrogenic for 10 (16.7%; 9.3-28.0). Chest drainage was used in 44 patients (73.3%; 61.0-82.9), universally in iatrogenic cases. After adjustment, age ≥ 60 years was independently associated with the receipt of chest drainage (adjusted OR 3.67; 95% CI 1.21-13.56; p = 0.026), with a prolonged length of stay (adjusted OR 3.69; 95% CI 1.02-21.00; p = 0.042) and with functional deterioration (adjusted OR 4.29; 95% CI 1.21-22.62; p = 0.028). Risk for falls (58.3%) and Bathing self-care deficit (26.7%) were the most frequent NANDA-I diagnoses; 14 patients (23.3%) deteriorated by at least one dependency category by discharge. Patients hospitalised with pneumothorax at our centre were predominantly older men with a substantial nursing-care workload. An older age was the most consistent independent correlate of both invasive treatment and adverse nursing-sensitive outcomes. The findings provide a descriptive baseline for the Croatian setting and should be interpreted as hypothesis-generating, given the modest sample size and the single-centre retrospective design.