Winnie Hedevang Olesen1, Rune Lindahl-Jacobsen2, Niels Katballe3, Jesper Eske Sindby4, Ingrid Louise Titlestad5, Poul Erik Andersen6, Peter Bjørn Licht7. 1. Department of Cardiothoracic Surgery, Odense University Hospital, 29 Sdr. Boulevard, 5000, Odense, DK, Denmark. winnie.olesen@rsyd.dk. 2. Danish Aging Research Center, Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark. 3. Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark. 4. Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark. 5. Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark. 6. Department of Radiology, Odense University Hospital, Odense, Denmark. 7. Department of Cardiothoracic Surgery, Odense University Hospital, 29 Sdr. Boulevard, 5000, Odense, DK, Denmark.
Abstract
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.
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.
Authors: S Kepka; J C Dalphin; A L Parmentier; J B Pretalli; M Gantelet; N Bernard; F Mauny; T Desmettre Journal: Can Respir J Date: 2017-03-30 Impact factor: 2.409
Authors: Winnie Hedevang Olesen; Ingrid Louise Titlestad; Poul Erik Andersen; Rune Lindahl-Jacobsen; Peter Bjørn Licht Journal: ERJ Open Res Date: 2019-06-10