title: Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment.
abstract: Previous studies on primary spontaneous pneumothorax reported variable recurrence rates, but they were based on heterogeneous patient populations including secondary pneumothorax. We investigated young patients with primary spontaneous pneumothorax exclusively and used a national registry to track readmissions and calculate independent predictors of recurrence.
  
  
  
  A prospective cohort study of consecutive young patients who were admitted over a 5-year period with their first episode of primary spontaneous pneumothorax and treated conservatively with a chest tube. Baseline characteristics were obtained from questionnaires presented on admittance. All patients were discharged with fully expanded lungs on chest radiography. Patient charts were identified in the national electronic patient registry for detailed information on readmissions due to recurrent spontaneous pneumothorax.
  
  
  
  We included 234 patients. Male/female = ratio 5/1. After a median observation period of 3.6 years (range 1-6 years), recurrent pneumothorax was observed in 54 %. Ipsilateral recurrence was the most common (79 %) but 30 % also experienced contralateral pneumothorax during the study period. Females had a significantly higher age at debut (p < 0.01) and experienced significantly more recurrences over time (p < 0.01). Low body weight (<60 kg) was an independent predictor of recurrence and patients with repeated recurrences were significantly younger at debut (p = 0.01).
  
  
  
  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.
authors.affiliation: Department of Cardiothoracic Surgery, Odense University Hospital, 29 Sdr. Boulevard, 5000, Odense, DK, Denmark. winnie.olesen@rsyd.dk.
authors.forename: Winnie Hedevang
authors.initials: WH
authors.lastname: Olesen
authors.affiliation: Danish Aging Research Center, Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark.
authors.forename: Rune
authors.initials: R
authors.lastname: Lindahl-Jacobsen
authors.affiliation: Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Katballe
authors.affiliation: Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jesper Eske
authors.initials: JE
authors.lastname: Sindby
authors.affiliation: Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Ingrid Louise
authors.initials: IL
authors.lastname: Titlestad
authors.affiliation: Department of Radiology, Odense University Hospital, Odense, Denmark.
authors.forename: Poul Erik
authors.initials: PE
authors.lastname: Andersen
authors.affiliation: Department of Cardiothoracic Surgery, Odense University Hospital, 29 Sdr. Boulevard, 5000, Odense, DK, Denmark.
authors.forename: Peter Bjørn
authors.initials: PB
authors.lastname: Licht
mesh_terms: D000293:Adolescent; D000328:Adult; D015505:Chest Tubes; D015331:Cohort Studies; D000072700:Conservative Treatment; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000453:epidemiology*; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D013851:Thinness / Q000453:epidemiology; D055815:Young Adult