Simple Aspiration for Spontaneous Pneumothorax in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Jiangli Cheng, Aijia Ma, Guopeng Liang
Published in: American Journal of Emergency Medicine, 2024 March 19
Conclusions:
- SA in adult SP management reduced the initial success rate compared to ITD but also shortened hospital stays and decreased the need for surgical intervention without increasing adverse events.
- The choice between SA and ITD should consider the balance between initial procedural success and overall patient burden, including hospitalization duration and surgical requirements.
Methods:
- Systematic search of EMBASE, Medline, and the Cochrane Central Register of Controlled Trials up to June 2023.
- Inclusion of randomized controlled trials (RCTs) comparing outcomes of SA and ITD in adult SP management.
Results:
- From 1447 citations, 10 RCTs with 1044 subjects were included.
- Compared to ITD, SA had a significantly lower initial success rate (OR 0.63, 95% CI [0.47-0.86]; P = 0.004).
- SA was associated with shorter hospital stays (mean difference -2.05 days, 95% CI [-2.66 - -1.44]; P < 0.001) and reduced need for surgery (P = 0.03).
- No significant difference was found between SA and ITD for adverse events like subcutaneous emphysema, bleeding, and wound infection.
- Subgroup analysis showed no significant difference in initial success rate, 1-week success rate, or adverse events between SA and ITD in primary spontaneous pneumothorax (PSP) patients.