title: Prolonged air leakage in secondary spontaneous pneumothorax: is proportion of emphysema important?
abstract: BACKGROUND
  Prolonged air leakage is the most common complication that can cause severe problems in cases of secondary spontaneous pneumothorax (SSP). The purpose of this study was to explore whether Goddard Classification Score (GCS) can be a marker of prolonged air leakage, particularly during the post-operative period, for patients with emphysema.
  
  
  METHODS
  Fifty patients, who underwent tube thoracostomy for SSP, were retrospectively evaluated. For the evaluation of emphysematous on the preoperative computed tomography image, visual scoring system described by Goddard was used. The correlations between age, duration of hospitalization, duration of drainage, number of pneumothorax episodes, prolonged air leakage and GCS parameters, were evaluated.
  
  
  RESULTS
  When 50 patients were scored, based on GCS, the distribution was as follows: G1: four cases, G2: 16 cases, G3: 17 cases, and G4: 13 cases. The mean number of pneumothorax episodes was 1.3 ± 0.5, the mean duration of drainage was 15.7 ± 11.3 days, and the mean duration of hospitalization was 9.2 ± 5.1 days. Prolonged air leakage was seen in 26 (52.2%) cases. The rate of prolonged air leakage was significantly higher in higher GCS cases (P = 0.035). There was a positive correlation between age and GCS (P = 0.011). The number of pneumothorax episodes rose significantly with increasing GCS (P = 0.011). The duration of hospitalization increased with the growing number of pneumothorax episodes (P = 0.027).
  
  
  CONCLUSIONS
  Prolonged air leakage and the recurrence rate of SSP rise with increasing GCS. Taking this condition into consideration in the treatment algorithm can be helpful for clinicians in patient follow-up.
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Sevinc
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Seyda Ors
authors.initials: SO
authors.lastname: Kaya
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Tevfik Ilker
authors.initials: TI
authors.lastname: Akcam
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Kenan Can
authors.initials: KC
authors.lastname: Ceylan
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: Department of Radiology, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Seher
authors.initials: S
authors.lastname: Susam
mesh_terms: D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012008:Recurrence; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013907:Thoracostomy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Emphysema; Goddard classification; prolonged air leakega; secondary spontaneous pneumothorax