Spontaneous pneumothorax: pragmatic management and long-term outcome.
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 (Pleurocatheter) 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.
Vernejoux
J M
JM
Service des Maladies Respiratoires, Hôpital du Haut-Lèvêque, CHU Bordeaux, France. jean-marc.vernejoux@chu-bordeaux.fr
Raherison
C
C
Combe
P
P
Villanueva
P
P
Laurent
F
F
Tunon de Lara
J M
JM
Taytard
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001827:Body Height; D002000:Bronchospirometry / Q000379:methods; D015505:Chest Tubes; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome