title: Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality.
abstract: Background. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP).Methods. We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis.Results. In the SSP group (n= 327; 34.9%), patient age, requirement for emergency transport, and length of stay were greater (all,p< 0.001), while the prevalence of smoking (p= 0.023) and number of surgical interventions (p< 0.001) were lower compared to those in the PSP group (n= 611; 65.1%). Among the 16 in-hospital deceased patients, 12 (75.0%) received emergency transportation and 10 (62.5%) exhibited performance status (PS) of 3-4. In the SSP group, emergency transportation was an independent factor for in-hospital mortality (odds ratio 16.37; 95% confidence interval, 4.85-55.20;p< 0.001).Conclusions. The prevalence and clinical characteristics of PSP and SSP differ considerably. Patients with SSP receiving emergency transportation should receive careful attention.
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Takuya
authors.identifier: 0000-0001-5582-956X
authors.initials: T
authors.lastname: Onuki
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yamaoka
authors.affiliation: Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sekiya
authors.affiliation: Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Araki
authors.affiliation: Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Wakai
authors.affiliation: Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Inagaki
authors.affiliation: Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsumiya
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000401:mortality* / Q000628:therapy; D015995:Prevalence; D012008:Recurrence