Clinical characteristics and risk factors for mortality analysis of 94 cases of rheumatic diseases with pneumomediastinum
10.3760/cma.j.cn141217-20200811-00305
- VernacularTitle:风湿性疾病合并纵隔气肿94例临床特征及死亡危险因素分析
- Author:
Meie LIANG
1
;
Can LI
;
Hui JIANG
;
Jiuliang ZHAO
;
Chanyuan WU
;
Qian WANG
;
Yan ZHAO
;
Liyun ZHANG
Author Information
1. 山西白求恩医院 山西医学科学院 山西医科大学第三医院风湿免疫科，太原 030032
- Keywords:
Rheumatic diseases;
Dermatomyositis;
Mediastinal emphysema;
Lung disease, interstitial;
Risk factors
- From:
Chinese Journal of Rheumatology
2021;25(8):510-515,C8-1
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics and risk factors of rheumatic diseases complicated with Pneumomediastinum (PnM).Methods:A retrospective analysis of 94 inpatients with rheumatic diseases associated PnM from Peking Union Medical College Hospital and Shanxi Bethune Hospital between January 1998 and October 2018 was carried out. Patients were divided into idiopathic inflammatory myopathies (IIM) and the non-IIM group. Clinical features, laboratory examinations and treatment were compared between the two groups. Cox proportional hazard model was used to investigate the risk factors for prognosis.Results:A total of 94 patients were included in the study, with an average age of (45±14) years. Forty-five (48%) of them were male. There were 62 patients in the IIM group and the other 32 were in the non-IIM group. Sixty-nine patients had predisposing factors before PnM. Severe cough and assisted mechanical ventilation were the most common causes. Compared with the non-IIM group, the incidence of digital vasculitis (29% vs 6%, χ2=6.540, P=0.008), arthritis (60% vs 28%, χ2=8.409, P=0.004), interstitial lung disease (ILD)(98% vs 78%, χ2=11.129, P=0.002) were higher in the IIM group, treatment with cyclophosphamide was higher in the IIM group ( χ2=4.458, P=0.035). There was non-significant difference in mortality between the two groups during hospitalization (50% vs 59%) and 6 months after PnM (64% vs72%) ( P>0.05). Pulmonary infection was the only risk factor for poor prognosis [ HR=3.131, 95% CI (1.025, 9.561), P=0.045], in which bacteria infection was the most common cause (65/75, 86.7%). Conclusion:PnM is a severe complication of rheumatic diseases. To get a good prognosis, rheumatol-ogists should balance the benefit and risk of infection of immunosuppressive therapy.
