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

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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.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Odense University Hospital, 29 Sdr. Boulevard, 5000, Odense, DK, Denmark

    Winnie Hedevang Olesen & Peter Bjørn Licht

  2. Danish Aging Research Center, Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark

    Rune Lindahl-Jacobsen

  3. Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark

    Niels Katballe

  4. Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark

    Jesper Eske Sindby

  5. Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark

    Ingrid Louise Titlestad

  6. Department of Radiology, Odense University Hospital, Odense, Denmark

    Poul Erik Andersen

Authors
  1. Winnie Hedevang Olesen
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  2. Rune Lindahl-Jacobsen
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  7. Peter Bjørn Licht
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Corresponding author

Correspondence to Winnie Hedevang Olesen.

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None of the authors declare any conflict of interest.

Funding

This work was supported by the Danish Lung Association.

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Olesen, W.H., Lindahl-Jacobsen, R., Katballe, N. et al. Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment. World J Surg 40, 2163–2170 (2016). https://doi.org/10.1007/s00268-016-3508-z

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  • DOI: https://doi.org/10.1007/s00268-016-3508-z

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