Incidence and Risk Factors of Iatrogenic Pneumothorax after Thoracentesis in Medical Wards: A 1-year Prospective Single-center Study

Abstract

Introduction: Iatrogenic pneumothorax (IP) after thoracentesis can lead to life-threatening conditions and increased treatment costs. Understanding the associated risk factors is crucial for prevention.

Objectives: This study aims to investigate the incidence of IP and its contributing risk factors.

Methods: This one-year prospective consecutive study was conducted in a tertiary teaching hospital,
documenting all thoracentesis procedures performed in the medical wards from July 2021
to June 2022.

Results: Data were collected from a total of 47 procedures involving 39 patients, with a mean age (SD) of 69.4 (13.9) years. Among the patients, 21 (53.9%) were male. The incidence of IP was 10.6% (5 events). Most incidents (80.0%) took place in the general ward, while the remaining 20.0% occurred in the intensive care units (p = 0.136). Notably, periprocedural events, particularly coughing, were reported in 80.0% of IP cases (IRR 8.40, 95% CI [3.00, 23.53], p < 0.001). No significant associations were found between IP and factors such as body mass index, use of mechanical ventilator, drainage volume, needle type, number of attempts, or the quarter of the training year in which the procedures were performed.

Conclusions: Over the course of the year, the incidence of IP following thoracentesis was found to be low. Although specific risk factors could not be identified, peri-procedural events warrant careful consideration, as they may indicate an increased likelihood of this complication.