Predictive factors of extended drainage in tuberculous pneumothorax

Background: Tuberculous pneumothorax (TP) is a rare and serious complication of tuberculosis. Its management is a real challenge for physicians. The aim of our study is to identify the predictors of extended drainage in TP. Methods: Retrospective, multicentric and analytical study including 69 patients hospitalized for SP secondary to TB between January 1999 and December 2020 in pneumology departments of Tunis. Extended drainage was defined by a drainage period more than 30 days. Two groups were individualized: Patients with extended drainage (G1) and the rest of the patients (G2). Results: Among the 69 cases collected, 36 patients had chronic chest drainage (G1). G1 patients had longer mean period of drainage (66± 38 vs 12± 8; p=0.001). There was no statistically significant difference between the mean age of the 2 groups (35,3±13.8 Vs 38.2±19; p=0.15). Diabetes mellitus was noted in 9 cases of G1 and 3 of G2 (p=0.199). Acute respiratory failure (ARF) was more frequent in G1 patients (13 vs 2; p=0.004). Broncho-pleural fistula was noted in 4 patients of G1 and only one patient of G2 (p=0.336). Extensive parenchymal lesions affecting at least one lung field were more common in G1 (12 vs 6; p=0.273). Two cases of bilateral SP secondary to TB were noted in G1 patients vs a single case in G2 patients (p=0.6). Conclusion: ARF during tubercular pneumothorax is a major predictive factor of prolonged chest drainage.