title: Surgical results of video-assisted thoracic surgery and risk factors for prolonged hospitalization for secondary pneumothorax in elderly patients.
abstract: BACKGROUND
  The treatment of secondary pneumothorax in elderly patients is difficult because of underlying diffuse lung injury and complex medical comorbidities. Such patients still have high morbidity rates, resulting in longer periods of hospitalization.
  
  
  METHODS
  To examine the results of video-assisted thoracic surgery for elderly patients (aged 70 years or over) with secondary pneumothorax and investigate the risk factors for hospital stay longer than 7 days, we retrospectively analyzed the results obtained in such patients at our institution.
  
  
  RESULTS
  From among 73 patients who entered this study, 7 patients (9.6%) had postoperative complications. Video-assisted thoracic surgery could treat pneumothorax in 71 patients, except for the 2 who died in hospital. The median postoperative drainage and hospital stay periods were 2 days (1-40 days) and 5 days (2-51 days). Patients with interstitial pneumonitis, pulmonary infection and low total protein or sodium levels were the risk factors for hospital stay longer than 7 days.
  
  
  CONCLUSIONS
  VATS is a safe and effective procedure for secondary pneumothorax in elderly patients. Patients with interstitial pneumonitis, pulmonary infection, and hyponutrition state were the risk factors for postoperative hospital stay prolongation.
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan. katccha@ares.eonet.ne.jp
authors.forename: Katsunari
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kuroda
authors.forename: Angyoung
authors.initials: A
authors.lastname: Kang
authors.forename: Naoko
authors.initials: N
authors.lastname: Imanishi
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Nagai
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ueda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D016009:Chi-Square Distribution; D004322:Drainage; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D017563:Lung Diseases, Interstitial / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000150:complications / Q000503:physiopathology; D009752:Nutritional Status; D011030:Pneumothorax / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012141:Respiratory Tract Infections / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D012964:Sodium