title: Pneumothorax in cardiac pacing: a population-based cohort study of 28,860 Danish patients.
abstract: OBJECTIVE
  To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.
  
  
  RESULTS
  A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary disease [aOR 3.9 (1.6-9.5)], implantation of a dual-chamber PM [aOR 1.5 (1.0-2.2)], venous access with subclavian vein puncture [aOR 7.8 (4.9-12.5)], venous access with both subclavian vein puncture and cephalic vein cut-down [aOR 5.7 (3.0-10.8)], and implantation in a non-university centre [aOR 2.1 (1.6-2.9)].
  
  
  CONCLUSIONS
  Pneumothorax treated with a chest tube remains a clinically important problem in device therapy. The cephalic vein cut-down technique should be applied whenever possible to avoid this complication.
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark. reki@svf.au.dk
authors.forename: Rikke Esberg
authors.initials: RE
authors.lastname: Kirkfeldt
authors.forename: Jens Brock
authors.initials: JB
authors.lastname: Johansen
authors.forename: Ellen Aagaard
authors.initials: EA
authors.lastname: Nohr
authors.forename: Mogens
authors.initials: M
authors.lastname: Moller
authors.forename: Per
authors.initials: P
authors.lastname: Arnsbo
authors.forename: Jens Cosedis
authors.initials: JC
authors.lastname: Nielsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D015505:Chest Tubes; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011030:Pneumothorax / Q000209:etiology* / Q000628:therapy; D012042:Registries; D012307:Risk Factors