Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment

• Published in: World journal of surgery Vol. 40; no. 9; pp. 2163 - 2170
• Main Authors: Olesen, Winnie Hedevang, Lindahl-Jacobsen, Rune, Katballe, Niels, Sindby, Jesper Eske, Titlestad, Ingrid Louise, Andersen, Poul Erik, Licht, Peter Bjørn
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Adult; Cardiac Surgery; Chest Radiography; Chest Tube; Chest Tubes; Cohort Studies; Conservative Treatment; Denmark - epidemiology; Female; General Surgery; Humans; Male; Medicine; Medicine & Public Health; Original Scientific Report; Pneumothorax; Pneumothorax - epidemiology; Recurrence; Recurrence Rate; Registries; Risk Factors; Sex Factors; Spontaneous Pneumothorax; Surgery; Thinness - epidemiology; Thoracic Surgery; Vascular Surgery; Young Adult; Pneumothorax; Chest Radiography; Chest Tube; Recurrence Rate; Spontaneous Pneumothorax
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3508-z

Introduction Previous studies on primary spontaneous pneumothorax reported variable recurrence rates, but they were based on heterogeneous patient populations including secondary pneumothorax. We investigated young patients with primary spontaneous pneumothorax exclusively and used a national registry to track readmissions and calculate independent predictors of recurrence. Methods A prospective cohort study of consecutive young patients who were admitted over a 5-year period with their first episode of primary spontaneous pneumothorax and treated conservatively with a chest tube. Baseline characteristics were obtained from questionnaires presented on admittance. All patients were discharged with fully expanded lungs on chest radiography. Patient charts were identified in the national electronic patient registry for detailed information on readmissions due to recurrent spontaneous pneumothorax. Results We included 234 patients. Male/female = ratio 5/1. After a median observation period of 3.6 years (range 1–6 years), recurrent pneumothorax was observed in 54 %. Ipsilateral recurrence was the most common (79 %) but 30 % also experienced contralateral pneumothorax during the study period. Females had a significantly higher age at debut ( p  < 0.01) and experienced significantly more recurrences over time ( p  < 0.01). Low body weight (<60 kg) was an independent predictor of recurrence and patients with repeated recurrences were significantly younger at debut ( p  = 0.01). Conclusions Primary spontaneous pneumothorax in younger patients with their first episode had a much higher recurrence rate than previously reported. Every doctor who treats patients with primary spontaneous pneumothorax should be aware and patients informed.