Abstract
Objectives: Pneumothorax (PTX) in newborns is a life-threatening
condition associated with high morbidity and mortality especially in
premature infants. The frequency of PTX in neonates at different
gestational ages (GA) and its impact on neonatal mortality have not been
quantified. We aimed to determine: 1) the prevalence of PTX in neonates
at different GA from ≤24 weeks to ≥37 weeks, 2) the impact of PTX on
mortality per GA, and 3) the impact of PTX on the length of stay (LOS)
per GA. Methods: The national Kids’ Inpatient Database (KID) for the
years of 2006 to 2012 were used. We included all infants admitted to the
hospital with a documented GA and ICD9 code of pneumothorax. Bivariate
and multivariate analyses were conducted and odds ratios (OR) were
calculated. Results: A total of 10 625 036 infants were included; of
them 3665 infants (0.034 %) had a diagnosis of PTX, with highest
prevalence at ≤24 weeks GA (0.67%), and lowest at term (0.02%). The
overall mortality rate of patients with PTX was 8.8%, and greater in
preterm (16.3%) vs. term infants (2.7%). The association of mortality
with PTX was greatest at GA of 29−32 weeks (OR = 8.55 (95% CI:
6.56−11.13). Infants who survived until discharge had a median of 2–12
days longer length of stay depending on GA category. Conclusions: The
prevalence of PTX peaks in infants <24 weeks, however its
impact on mortality is greatest at 29-32 weeks. PTX is associated with
longer length of stay in survivors.