Factors related to recurrence of spontaneous pneumothorax.
OBJECTIVE
The purpose of this retrospective study was to identify factors associated with recurrent spontaneous pneumothorax (SP) in southern China, and to compare the therapeutic effectiveness of different procedures.


METHODS
A total of 182 consecutive patients (89.0% male; mean age, 38.9 years), admitted with their first episode of pneumothorax, were reviewed retrospectively. Follow up was available in 138 patients (75.8%), including 68 treated by chemical pleurodesis and 70 by chest tube drainage alone. The cumulative recurrence rates with different therapeutic procedures and different chemical sclerosing agents were compared, and the factors that influenced the recurrence rate were analysed using Cox's proportional hazard model.


RESULTS
The most common pre-existing lung disease responsible for pneumothorax was COPD (69.7%), followed by tuberculosis (16.5%). Recurrence was significantly more common in taller patients, patients with lower weight, and patients with secondary spontaneous pneumothorax. The cumulative recurrence rates in the pleurodesis therapy group after 6 months, 1 and 3 years were 13, 16 and 27%, respectively, whereas in the chest tube drainage group the recurrence rates were 26, 33 and 50%, respectively (P < 0.05). There was no significant difference in the recurrence rate for those receiving tetracycline compared with those who received gentamicin.


CONCLUSIONS
Spontaneous pneumothorax patients who are taller, weigh less or have secondary spontaneous pneumothorax are more likely to have recurrences. The risk of recurrence is reduced in patients who undergo chemical pleurodesis. Since there was no significant difference between intrapleural tetracycline and gentamicin, gentamicin should be considered as a potential chemical sclerosing agent.
Guo
Yubiao
Y
Department of Pulmonary Medicine, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Xie
Canmao
C
Rodriguez
R Michael
RM
Light
Richard W
RW
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001827:Body Height; D001835:Body Weight; D002681:China / Q000453:epidemiology; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D008297:Male; D018700:Pleurodesis; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D013752:Tetracycline / Q000008:administration & dosage; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D013752:Tetracycline