Pneumomediastinum epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

Overview

Pneumomediastinum is a rare condition. Epidemiology of pneumomediastinum reflects the epidemiology of diseases associated with the condition.

The pneumomediastinum is a rare entity, diagnosed approximately 2.25 per 100,000 of accident and emergency admissions.^[1]^[2]
Pneumomediastinum has an incidence of 1 per 100,000 natural births, being more frequent in children (6-125 per 100,000 individuals).

Pneumomediastinum is a clinical condition with potential complications that can cause high morbidity and mortality rates.
A retrospective review of medical records from January 1, 2002, to December 31, 2011, was conducted at a university-based urban trauma center.^[3]
- According to the study, 72 patients out of 3327 (2.2%) patients with blunt trauma had pneumomediastinum.
- Patients with pneumomediastinum had higher Injury Severity (ISS) Scores (P < 0.001) and chest Abbreviated Injury Scale (AIS) scores (P < 0.001) compared with those without pneumomediastinum.
- Pneumomediastinum was associated with higher mortality (9 [12.5%] vs 118 [3.6%] patients; P < 0.001) and longer mean (SD) hospital stays (11.3 [14.6] vs 5.1 [8.8] days; P < 0.001), intensive care unit stays (5.4 [10.2] vs 1.8 [5.7] days; P < 0.001), and ventilator days (1.7 [4.2] vs 0.6 [4.0] days; P < 0.03).
- According to the study pneumomediastinum size was not associated with in-hospital mortality (P = 0.22). However, the location of air in the posterior mediastinum was associated with increased mortality of 25% (7 of 28 patients; P = 0.007).
- Air in all mediastinal compartments was also associated with increased mortality of 40.0% (4 of 10 patients; P = 0.01). Presence of hemothorax along with pneumomediastinum was associated with mortality of 22.2% (8 of 36 patients; P = 0.01).

Patients of all age groups may develop pneumomediastinum.
Infants have high incidence rates of pneumomediastinum.
The incidence of pneumomediastinum is high in the general population between the ages of 5 and 34 years, with the predominance being young adult men and pregnant women.
In a retrospective study, a prevalence of 30 per 100,000 children presenting in the emergency room with underlying asthma and acute exacerbation was reported. Mean age was 11.8 years with a male:female ratio of 1.15:1.^[4]
70% of cases of pneumomediastinum in children are due to exacerbation of asthma or respiratory tract infection.

Adult males are more commonly affected by pneumomediastinum than females. The male to female ratio is approximately 8:1.^[5]
In children male:female ratio is 1.15:1.

Geographical location has no effect on epidemiology of pneumomediastinum.

↑ . doi:10.3978/j.issn.2072-1439.2015.01.11. Missing or empty |title= (help)
↑ Macia, I; Moya, J; Ramos, R; Morera, R; Escobar, I; Saumench, J; Perna, V; Rivas, F (2007). “Spontaneous pneumomediastinum: 41 cases”. European Journal of Cardio-Thoracic Surgery. 31 (6): 1110–1114. doi:10.1016/j.ejcts.2007.03.008. ISSN 1010-7940.
↑ Lee, Wayne S.; Chong, Vincent E.; Victorino, Gregory P. (2015). “Computed Tomographic Findings and Mortality in Patients With Pneumomediastinum From Blunt Trauma”. JAMA Surgery. 150 (8): 757. doi:10.1001/jamasurg.2015.1138. ISSN 2168-6254.
↑ Stack AM, Caputo GL (April 1996). “Pneumomediastinum in childhood asthma”. Pediatr Emerg Care. 12 (2): 98–101. PMID 8859917.
↑ “Pneumomediastino espontâneo: Asma”.