Recurrence in spontaneous pneumothorax - 15 years review

Introduction: Spontaneous pneumothorax represents a common clinical problem and is usually a benign condition. Recurrence is the most common complication and may be influenced by several factors. Purpose: Identification of predictive factors of pneumothorax recurrence and the type of treatment performed. Methods: Retrospective review of 276 cases of patients hospitalized for spontaneous pneumothorax between 2003 and 2017. Categorical variables were compared by using the X2 test or Fisher9s exact test. Results: There was a predominance of males (84,4%) and smokers (50,7%). Pneumothorax was considered primary in 70% of cases with an average age of 28,4 ± 11 years, and secondary in 30% of cases with an average age of 52,4 ± 20,2 years. After the event, 32,9% of patients quit smoking and 53,6% maintained smoking habits. Thoracic drainage was performed in 256 patients (92.8%), conservative treatment in 20 patients (7.2%) and 70 (25.4%) were oriented to surgery. Pneumothorax recurrence was observed in 95 patients (34,3%). Previous history of pneumothorax (p=0,036) and the presence of blebs or bullae (p=0,030) were identified as risk factors for recurrence in these patients. Gender, age, type of pneumothorax (primary vs secondary), pulmonary emphysema and smoking habits, had no influence in recurrence. Conclusion: In this study the rate of recurrence is correlated with a previous history of pneumothorax and the existence of pulmonary bullae, being in agreement with the literature. Maintenance of smoking habits was not identified as a risk factor for recurrence, which may result from the lack of available data concerning this issue in some patients (13,5%).