Primary spontaneous pneumothorax: clinical profile, seasonality, and recurrence of 132 adult patients in a University Hospital, Kingdom of Saudi Arabia (original) (raw)
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Clinical profile and treatment outcome of patients with spontaneous pneumothorax
International Journal of Research in Medical Sciences, 2017
Background: The burden of Spontaneous Pneumothorax has been recorded as alarming health problem in medical sciences and is adversely influenced by environmental factors. Objectives of the study were to determine the incidence of spontaneous pneumothorax and to assess the clinical profile and outcome of patients of spontaneous pneumothorax admitted in Government tertiary health care centre.Methods: A hospital based cross-sectional study was conducted in year 2014-15 in the department of Pulmonary Medicine, Government Medical College, Miraj, Maharashtra, India. A total of 2142 patients were admitted with chest complaints during study period were enrolled as study subjects, of which 50 were diagnosed as spontaneous pneumothorax and treated as cases under study. The data were elicited by utilizing structured proforma includes clinical and outcome indicators of Spontaneous Pneumothorax. Qualitative information was computed in tabular and graphical form and analyzed into frequency percent...
Incidence of primary spontaneous pneumothorax: a validated, register-based nationwide study
ERJ Open Research
ObjectivesThe incidence of primary spontaneous pneumothorax is partly unknown. Commonly quoted estimates were published decades ago and recent large-scale epidemiological publications lack validation. We validated the pneumothorax diagnosis in a national registry and estimated the incidence of primary spontaneous pneumothorax in young patients.MethodsComplete data on patients with an assigned pneumothorax diagnosis was retrieved from the National Danish Patient Registry. Initially, we validated the diagnosis in a selected population: all patient charts with an assigned pneumothorax diagnosis from one cardiothoracic department over a 25-year period (1984–2008) were reviewed. Subsequently, the national incidence of primary spontaneous pneumothorax in young, healthy individuals was estimated by restricting our population to patients ≤40 years of age admitted during a 5-year period (2009–2014). We performed a systematic read-though of patient charts in 50% of the complete national cohor...
Outcome of patients with spontaneous pneumothorax admitted in Abbasia Chest Hospital
Egyptian Journal of Bronchology, 2016
Conclusion PSP was more frequent compared with SSP in our study, with a higher incidence in younger and taller male population. Smoking is an important risk factor for spontaneous pneumothorax, and the most common lung disease found in our study to be associated with SSP was chronic obstructive pulmonary disease. We conclude that PSP carries a lesser risk for complications and better outcome compared with SSP. The risk for mortality or major complications from spontaneous pneumothorax in general was negligible in our study.
Recurrence of primary spontaneous pneumothorax
Thorax, 1997
ondary to pulmonary tuberculosis up to 1932 when Kjaergard described primary spon-Background-Primary spontaneous pneumothorax (PSP) is a common clinical taneous pneumothorax (PSP) as a separate entity occurring in previously healthy adults. 3 problem and its incidence is thought to be increasing. The risk of recurrence is high Devilliers was the first to suggest the rupture of subpleural blebs as a cause for spontaneous and various studies quote rates of 20-60%. Factors which may or may not predispose pneumothorax and Hewson described thoracocentesis for its relief. 1 to recurrence have not yet been established. PSP is a common clinical problem occurring in apparently healthy subjects with a reported Methods-In a study period of four years 291 cases with a diagnosis of pneumo-incidence of 7.4-28/100 000 per year for men and 1.2/100 000 per year for women. 4 The thorax were reviewed; 153 patients with PSP were included in the study. Their risk incidence of PSP is believed to be increasing, and the recurrence rate has been variably re-of recurrence was analysed with particular reference to the following variables: age, ported as 20-60% 5 with few studies of predisposing risk factors. 6 7 sex, height and body mass index (BMI) of the patient, the initial size of pneumo-This retrospective study, which preceded publication of the BTS guidelines, 8 was con-thorax, the smoking status of the patient, and the primary form of treatment em-ducted to evaluate the recurrence rate of PSP with particular reference to the following vari-ployed. Univariate analysis was carried out by 2 testing and multivariate analysis ables: age, sex, height and BMI of the patient, initial size of the pneumothorax, smoking status was calculated by a logistic regression model. of the patient, and the primary form of treatment employed. Results-A retrospective study of 275 episodes of PSP in 153 patients over a four year period confirmed a high incidence of recurrence (54.2%). PSP was twice as Methods common in men as in women, though The study was carried out at a cardiothoracic women were significantly more likely to surgical centre (Castle Hill Hospital) for the develop a recurrence (2 =7.58, df=1, region of East Yorkshire. A total of 429 patients p<0.01). Male height was the second most with a diagnosis of pneumothorax were idenimportant factor, and smoking cessation tified from a computer-generated diagnostic the only other variable which significantly index for the period from February 1990 to influenced the risk of recurrence. March 1994. A proportion of patients (n= Conclusions-Analysis of several potential 104, 24%) were tertiary referrals for surgery risk factors revealed that recurrence was from neighbouring hospitals and were excluded not related to the BMI of the patient, the from the analysis to avoid selection bias. Miss-Medical Chest Unit, initial treatment of the pneumothorax, nor ing data (case notes or radiographs) for 34 Castle Hill Hospital, to its size. Recurrence was more common North Humberside, patients (8%) left 291 case records for detailed in taller men and in women. Smoking ces-UK study. R T Sadikot sation appeared to reduce the risk of re-Patients were entered into the study if they A G Arnold currence. These findings are discussed in were older than 15 years and if the initial index the context of the possible aetiology of Department of Public episode of pneumothorax occurred during the Health Medicine, spontaneous pneumothorax, recurrences, study period. The following data were col-University of Hull, and the management thereof. North Humberside, lected: (1) age and sex, (2) height and weight, (Thorax 1997;52:805-809) UK (3) smoking habits, (4) associated lung dis-T Greene eases, (5) side and size of pneumothorax, and
INDIAN JOURNAL OF APPLIED RESEARCH X 695 Clinical Study of Spontaneous Pneumothorax
Background: Pneumothorax is classified into traumatic and spontaneous. Spontaneous pneumothorax divided into primary spontaneouspneumothorax if there is no clinical evidence of lung disease and secondary spontaneous pneumothorax associated with lung disease. Method: Prospective observational study done at Pulmonary medicine department, Kurnool medical college. We studied the causes, presenting features, management and outcome of Spontaneous Pneumothorax in this study. Patients admitted in pulmonary medicine ward with a diagnosis of spontaneous pneumothorax were classified as primary spontaneous Pneumothorax (PSP) and Secondary spontaneous Pneumothorax (SSP). The diagnosis was made by chest radiograph, and computed Tomography if necessary. Necessary investigations done for confirmation of lung disease in SSP. Depending on clinical features, extent of pneumothorax and underlying lung disease management decided as observation with oxygen inhalation or aspiration or Intercostal ChestTube Drainage (ICTD) with under water seal. Supportive treatment given to all patients and Specific treatment for underlying lung disease given in SSP. Results : Total 69 patients were included in this studymales were more 48(69.6%). Mean age was 44.9 yrs(range 20 to 70 yrs). Out of 69 PSP were 10 (14.5%) and SSP were 59(85.5%). Lung diseases in SSP were Tuberculosis 33, Chronic obstructive pulmonary (COPD) disease 20, Asthma 2, interstial lung diseases 2 and pneumonia2. Treated with observation and oxygen inhalation 4 , with aspiration10 and with ICTD 55.In PSP cases lung expansion occurred-in 2 to 8 days. In SSP cases lung expansion occurred in 4-30 days.4 cases of SSP referred for surgery. Conclusion:Spontaneous Pneumothorax is more common in males.In majority of PSP dyspnoea is less, can be managed by observation with oxygen inhalation or by aspiration.Tuberculosis is the common cause for SSP in India and should be looked for in all spontaneous pneumothorax cases. Majority cases of SSP are managed by ICTD. Compared to SSP hospital stay in PSP is short Introduction : Pneumothorax is an emergency so early recognition and prompt treatment saves the patient. Pneu-mothorax classified into spontaneous and traumatic. Spontaneous pneumothorax divided into primary spontaneous Pneumothorax (PSP) if there is no clinical evidence of lung disease and secondary spontaneous pneumothorax (SSP) associated with underlying lung disease 1. This study is under taken to study the causes, clinical presentation, mode of management and response to treatment in spontaneous pneumothorax
Annals of Thoracic and Cardiovascular Surgery, 2014
Surgical treatment of primary spontaneous pneumothorax (PSP) is usually performed in cases of prolonged air leak (PAL) or recurrence. We investigated the effect of the size of pneumothorax in surgically treated PSP cases. Methods: Between 2007 and 2008, 181 patients hospitalized with the diagnosis of PSP were prospectively recorded. The size of pneumothorax was calculated in percentages by the method defined by Kircher and Swartzel. Patients were divided into two groups, according to pneumothorax size: Group A (large pneumothorax, ≥50%), and Group B (small or moderate pneumothorax, <50%). Results: The mean size of pneumothorax was 80.5 ± 10.4% in Group A (n = 54, 29%) and 39.5 ± 6.5% in Group B (n = 127, 71%). History of smoking and smoking index were significantly higher in Group A patients (p = 0.02, p <0.001, respectively). Fifty-five patients (29.3%) required surgery because of PAL or ipsilateral recurrence. The rate of patients requiring surgical operation was significantly higher in Group A (51.9%) than in Group B (n = 25; p <0.001). Rates of PAL and recurrence were higher in Group A than in Group B (p = 0.007, p = 0.004, respectively). Conclusion: The size of pneumothorax is larger in those with a smoking history and a higher smoking index. Surgical therapy can be considered in cases with a pneumothorax size ≥50% after the first episode immediately.
Primary spontaneous pneumothorax in Arabs: does its frequency differ from elsewhere?
Journal of clinical …, 2000
No data are available on primary spontaneous pneumothorax (PSP) in Arabs. Hence we sought to determine its characteristics in Arabs of the Al-Ahmadi Governorate in Kuwait. All patients over 10 years of age with pneumothorax who were admitted to the only free general hospital serving Ahmadi area from 1985 to 1996 were reviewed retrospectively. The study included all patients' medical records, investigations, treatment, morbidity, and mortality. Any patient with secondary pneumothorax was excluded. Primary spontaneous pneumothorax was rare in female Arabs, as they are almost never smokers. There were only two females out of total 58 patients with an incidence of 0.3 per 100,000 per year. Its incidence in male Arabs was 8.8 per 100,000 per year, similar to that in other studies. The distribution had a monophasic pattern, the average age being 23 (Ϯ 7.3 SD) years at the first episode. Smoking, a tall, asthenic (slim, relatively weak in appearance, ectomorphic) body build, and a positive family history are the most important risk factors and are not different from most studies conducted in other parts of the world.
Electronic Journal of General Medicine
INTRODUCTION Primary spontaneous pneumothorax (PSP) is a common health problem in patients referring to emergency departments (1). Primary spontaneous pneumothoraces occur in people aged 20-30 years and peak incidence is in the early twenties (2). For men, age-adjusted incidence of primary spontaneous pneumothorax is 7,4 to 18 cases per 100,000 persons per year (3). The overall recurrence rate is about 23 to 50% for primary spontaneous pneumothorax after the first attack (2). PSP is typically associated with the rupture of an apical subpleural bleb with no other predisposing lung disease or history of trauma (4). Several treatment options are available for the treatment of PSP such as observation, supplemental oxygen, and simple aspiration, tube thoracostomy with or without the installation of a sclerosing agent, thoracoscopy, and open thoracotomy. A consensus does not exist concerning the treatment of PSP (5).
ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax
The European respiratory journal, 2015
Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is ava...