National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement

Introduction Spontaneous pneumothorax (SP) affects both young, otherwise healthy individuals and older persons with known underlying pulmonary disease. Initial management possibilities are evolving and range from observation to chest tube insertion. SP guidelines suggest an individualized approach b...

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Main Authors: Søren Helbo Skaarup, Christian B. Laursen, Rob J Hallifax, Beenish Iqbal, Uffe Bødtger
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:European Clinical Respiratory Journal
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Online Access:https://www.tandfonline.com/doi/10.1080/20018525.2024.2307648
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author Søren Helbo Skaarup
Christian B. Laursen
Rob J Hallifax
Beenish Iqbal
Uffe Bødtger
author_facet Søren Helbo Skaarup
Christian B. Laursen
Rob J Hallifax
Beenish Iqbal
Uffe Bødtger
author_sort Søren Helbo Skaarup
collection DOAJ
description Introduction Spontaneous pneumothorax (SP) affects both young, otherwise healthy individuals and older persons with known underlying pulmonary disease. Initial management possibilities are evolving and range from observation to chest tube insertion. SP guidelines suggest an individualized approach based on multiple factors such as symptoms, size of pneumothorax, comorbidity and patient preference.Aim With this Danish national survey we aimed to map organization of care including involved specialties, treatment choice, training, and follow-up plans to identify aspects, and optimization of spontaneous pneumothorax management.Method A survey developed by the national interest group for pleural medicine was sent to all departments of emergency medicine, thoracic surgery, respiratory medicine, and to relevant departments of abdominal or orthopaedic surgery.Results The response rate was 75 % (47 of 65). Overall, 21% of responding departments had no guideline for SP management, which was provided by multiple specialties with marked heterogeneity in choice of treatment including tube size, management during admission, and referral procedure to follow-up. Few departments required procedure training, and nearly all of the responders called for improvements in management of pneumothorax.Conclusion This survey suggests that SP management and care is delivered heterogeneously across Danish hospitals with marked difference between respiratory physicians, emergency physicians, general surgeons and thoracic surgeons. It is therefore likely that management is sub-optimal. There is a need for a common Danish SP guideline to ensure optimal treatment across involved specialties.
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spelling doaj-art-27021971bc884bfba26e32b320e45e892025-08-20T02:27:43ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252024-12-0111110.1080/20018525.2024.2307648National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvementSøren Helbo Skaarup0Christian B. Laursen1Rob J Hallifax2Beenish Iqbal3Uffe Bødtger4Department of Respiratory Medicine and Allergy, University Hospital. The Danish Respiratory Society’s interest group for pleural diseases, Aarhus, DenmarkOdense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, DenmarkOxford Respiratory Trials Unit, Churchill Hospital, University of Oxford, Oxford, UKOxford Respiratory Trials Unit, Churchill Hospital, University of Oxford, Oxford, UKRespiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital Roskilde & Næstved, Zealand, DenmarkIntroduction Spontaneous pneumothorax (SP) affects both young, otherwise healthy individuals and older persons with known underlying pulmonary disease. Initial management possibilities are evolving and range from observation to chest tube insertion. SP guidelines suggest an individualized approach based on multiple factors such as symptoms, size of pneumothorax, comorbidity and patient preference.Aim With this Danish national survey we aimed to map organization of care including involved specialties, treatment choice, training, and follow-up plans to identify aspects, and optimization of spontaneous pneumothorax management.Method A survey developed by the national interest group for pleural medicine was sent to all departments of emergency medicine, thoracic surgery, respiratory medicine, and to relevant departments of abdominal or orthopaedic surgery.Results The response rate was 75 % (47 of 65). Overall, 21% of responding departments had no guideline for SP management, which was provided by multiple specialties with marked heterogeneity in choice of treatment including tube size, management during admission, and referral procedure to follow-up. Few departments required procedure training, and nearly all of the responders called for improvements in management of pneumothorax.Conclusion This survey suggests that SP management and care is delivered heterogeneously across Danish hospitals with marked difference between respiratory physicians, emergency physicians, general surgeons and thoracic surgeons. It is therefore likely that management is sub-optimal. There is a need for a common Danish SP guideline to ensure optimal treatment across involved specialties.https://www.tandfonline.com/doi/10.1080/20018525.2024.2307648Spontaneous pneumothoraxNational surveyClinical decision makingChoice of chest tube typeProcedure trainingOptimizing treatment needs
spellingShingle Søren Helbo Skaarup
Christian B. Laursen
Rob J Hallifax
Beenish Iqbal
Uffe Bødtger
National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
European Clinical Respiratory Journal
Spontaneous pneumothorax
National survey
Clinical decision making
Choice of chest tube type
Procedure training
Optimizing treatment needs
title National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
title_full National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
title_fullStr National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
title_full_unstemmed National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
title_short National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement
title_sort national survey on management of spontaneous pneumothorax from emergency department to specialised treatment room for improvement
topic Spontaneous pneumothorax
National survey
Clinical decision making
Choice of chest tube type
Procedure training
Optimizing treatment needs
url https://www.tandfonline.com/doi/10.1080/20018525.2024.2307648
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