Spontaneous pneumothorax: Pragmatic management and long-term outcome

Abstract

We prospectively considered 65 patients admitted for a spontaneous pneumothorax (SP) to describe the pragmatic management of SP, the first recurrence-free interval after medical therapeutic procedure and to specify the first recurrence risk factors over a 7-year period in these patients treated medically. The treatment options were observation alone (9%), needle aspiration (6%), small calibre chest tube (Pleuro-catheter ®) drainage (28%) or thoracic tube drainage (49%), and pleurodesis with video-assisted thoracic surgery procedure (8%). Duration of the drainage and length of hospital stay were shorter in the Pleurocatheter® group than in the thoracic tube group (P < 0.01). Among the 47 patients (72%) with a first SP and treated medically, nine patients (19%) had a first homolateral recurrence (FHR) during a mean follow-up of 84 ± 13 months. Recurrence-free intervals ranged from 1 to 24 months (mean ± SD: 9.3 ± 8.4 months). FHR cases were more frequent in the Pleurocatheter® group (P < 0.04). Analysis of potential risk factors showed that the patient's height and a previous homolateral SP episode are independent recurrence risk factors. © 2001 Harcourt Publishers Ltd.