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

Olesen, Winnie Hedevang; Lindahl-Jacobsen, Rune; Katballe, Niels; Sindby, Jesper Eske; Titlestad, Ingrid Louise; Andersen, Poul Erik; Licht, Peter B.

doi:10.1007/s00268-016-3508-z

Cited by 52 publications

(65 citation statements)

References 38 publications

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“…Smoking is thus often presented as a risk factor for recurrence [3, 15]. Even though recurrence seems to occur earlier in smokers [9], we failed to find a significant relation between smoking and recurrence in our study, as in other studies [9, 13]. Furthermore, smokers could have a significant reduced risk of recurrence compared to nonsmokers [13].…”

Section: Discussioncontrasting

confidence: 72%

“…Even though recurrence seems to occur earlier in smokers [9], we failed to find a significant relation between smoking and recurrence in our study, as in other studies [9, 13]. Furthermore, smokers could have a significant reduced risk of recurrence compared to nonsmokers [13]. An association between the use of cannabis and pneumothorax has been suggested in previous studies [1, 16–18], but no studies have explored the link between cannabis use and PSP recurrence.…”

Section: Discussioncontrasting

confidence: 65%

“…Furthermore, some potential factors associated with recurrence were not studied. Other authors have found that a low body mass index is a risk factor for recurrence [9, 13, 20]. We were unable to study this factor because it was not available in medical files of EDs.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, studies investigating the impact of tobacco and cannabis smoking, gender, or age, on the recurrence of PSP have shown contradictory results [9–11]. However, these studies included small sample sizes [9, 12, 13] and recurrence was often studied at one year as a criteria evaluating treatment success. Data concerning recurrence are therefore incomplete, and the characteristics of patients presenting with recurrent SP are poorly documented.…”

Section: Introductionmentioning

confidence: 99%

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Primary Spontaneous Pneumothorax Admitted in Emergency Unit: Does First Episode Differ from Recurrence? A Cross-Sectional Study

Kepka

Dalphin

Parmentier

et al. 2017

Canadian Respiratory Journal

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Introduction. Management of primary spontaneous pneumothorax (PSP) consists of immediate resolution of pleural air, or observation, and prevention of recurrence. The risk factors for recurrence remain debated. Objectives. We aimed to describe and compare the characteristics of patients presenting a first episode of PSP to those of patients presenting a recurrent PSP, in order to identify factors potentially related to recurrence. Methods. We conducted a cross-sectional study including all admissions for PSP in the EDs of fourteen French public hospitals from 2009 to 2013. PSP were classified as a first episode if the patient had no previous history of pneumothorax and as recurrence if a previous episode of spontaneous pneumothorax was documented in the patient's medical records or if a recurrence was identified during the inclusion period. To identify factors potentially associated with recurrence of PSP, multilevel logistic models were fitted. Results. During the study period, 918 (61,6%) first episodes and 573 (38,4%) episodes of recurrent PSP were identified. Clinical presentation, age, gender, smoking habits, and use of cannabis were similar in both groups. No clinical factor associated with recurrence was identified by multivariate analysis. Conclusion. In this large multicenter study, no clinical factor associated with recurrence was highlighted.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary Spontaneous Pneumothorax Admitted in Emergency Unit: Does First Episode Differ from Recurrence? A Cross-Sectional Study

Kepka

Dalphin

Parmentier

et al. 2017

Canadian Respiratory Journal

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“…In a prospective randomized study, Noppen et al [34] observed a recurrence rate of 26% one year after aspiration, and a recurrence rate of 27.3% after drainage therapy in the same time period. A recent Danish prospective cohort study [35] showed a recurrence rate in PSP of 54% after drainage therapy, the median observation time here was 3.6 years.…”

Section: Recurrence Ratementioning

confidence: 54%

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

et al. 2018

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In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery, in co-operation with the German Society for Pulmonology, the German Radiological Society, and the German Society of Internal Medicine has developed an S3 guideline on spontaneous pneumothorax and post-interventional pneumothorax moderated by the German Association of Scientific Medical Societies. Method: Based on the source guideline of the British Thoracic Society (2010) for spontaneous pneumothorax, a literature search on spontaneous pneumothorax was carried out from 2008 onwards, for post-interventional pneumothorax from 1960 onwards. Evidence levels according to the Oxford Center for Evidence-Based Medicine (2011) were assigned to the relevant studies found. Recommendations according to grade (A: “we recommend”/“we do not recommend,” B: “we suggest”/“we do not suggest”) were determined in 3 consensus conferences by the nominal group process. Results: The algorithms for primary and secondary pneumothorax differ in the indication for CT scan as well as in the indication for chest drainage application and video-assisted thoracic surgery. Indication for surgery is recommended individually taking into account the risk of recurrence, life circumstances, patient preferences, and procedure risks. For some forms of secondary pneumothorax, a reserved indication for surgery is recommended. Therapy of post-interventional spontaneous pneumothorax is similar to that of primary spontaneous pneumothorax. Discussion: The recommendations of the S3 Guideline provide assistance in managing spontaneous pneumothorax and post-interventional pneumothorax. Whether this will affect existing deviant diagnostic and therapeutic measures will be demonstrated by future epidemiological studies.

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The Evolving Epidemiology and Management of Spontaneous Pneumothorax

Savitsky

Lee

2018

JAMA

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Spontaneous pneumothorax represents air trapped within the pleural space that develops without antecedent trauma. Current understanding regarding the epidemiology of spontaneous pneumothorax has been informed by small studies performed at single medical centers or retrospective reviews of national data registries. 1,2 The overall incidence of spontaneous pneumothorax has been estimated at 17 to 24/100 000 in the male population and 1 to 6/100 000 in the female population. 1-4 Spontaneous pneumothorax recurrence rates have primarily been extrapolated from retrospective case series, with 1-to 6-year recurrence rates ranging from 17% to 54%. 5,6 In this issue of JAMA, Hallifax et al 7 characterize the epidemiology of this condition over 5 decades with an analysis of inpatient-treated spontaneous pneumothorax in England. They report national estimates of incidence and recurrence by age group, sex, and presence or absence of chronic lung disease.The authors used the historical definition of primary spontaneous pneumothorax, which is a spontaneous pneumothorax diagnosed in a patient with no previously identified underlying lung disease or chest trauma. 8 Secondary spontaneous

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

Abstract: 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.

Cited by 52 publications

References 38 publications

Primary Spontaneous Pneumothorax Admitted in Emergency Unit: Does First Episode Differ from Recurrence? A Cross-Sectional Study

Primary Spontaneous Pneumothorax Admitted in Emergency Unit: Does First Episode Differ from Recurrence? A Cross-Sectional Study

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

The Evolving Epidemiology and Management of Spontaneous Pneumothorax

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