Skip to main content

Outcome of patients with spontaneous pneumothorax admitted in Abbasia Chest Hospital

Abstract

Introduction

Spontaneous pneumothorax remains a significant global problem. It can present either in a primary form occurring in healthy individuals or in a secondary form essentially associated with an underlying lung disease. The primary goals of therapy are to remove air from the pleural space and to prevent recurrence. The choice of a therapeutic intervention is multifactorial.

Aim of the work

The aim of this study was to study the clinical course and outcome of patients with spontaneous pneumothorax in Abbasia Chest Hospital.

Patients and methods

This prospective study was conducted on 100 patients with spontaneous pneumothorax admitted in Abbasia Chest Hospital in Cairo, Egypt. Patients were divided into two main groups: group I, the primary spontaneous pneumothorax (PSP) group, and group II, the secondary spontaneous pneumothorax (SSP) group. Chest tube drainage was performed for patients with large PSP, small PSP increasing in size or associated with symptoms, and all patients with SSP. Patients were subjected to thoracic surgical interventions, whenever indicated.

Results

We included 100 patients with spontaneous pneumothorax: group I (PSP) consisted of 66 patients, and group II (SSP) consisted of 34 patients. Of them, 92% were male and 8% were female. Comparison between the two groups demonstrated that PSP occurs predominantly in male population, especially younger and taller individuals, whereas there was no significant difference in weight or BMI between the two groups. An overall 77% of all studied patients were smokers. PSP patients had a shorter hospital stay compared with SSP patients. The causes of SSP were chronic obstructive pulmonary disease (64.7%), bronchial asthma (2.9%), interstitial lung diseases (14.7%), tuberculosis (17.6%), and bronchiectasis (2.9%). All patients were subjected to chest tube drainage. Complications were found in 6% of patients in group I and in 26.4% of patients in group II. Different complications were noticed in the form of surgical emphysema, hydropneumothorax, persistent air leak, and pleural infection. In group I, only one patient (1.5%) required further interventions, whereas in group II 11.7% needed surgical interventions. Mortality occurred in three patients (8.8%) in group II. There was no evidence that any mortality was directly related to pneumothorax or its management.

Conclusion

PSP was more frequent compared with SSP in our study, with a higher incidence in younger and taller male population. Smoking is an important risk factor for spontaneous pneumothorax, and the most common lung disease found in our study to be associated with SSP was chronic obstructive pulmonary disease. We conclude that PSP carries a lesser risk for complications and better outcome compared with SSP. The risk for mortality or major complications from spontaneous pneumothorax in general was negligible in our study.

References

  1. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax 2000; 55:666–671.

    Article  CAS  Google Scholar 

  2. Noppen M, De Keukeleire T. Pneumothorax. Respiration 2008; 76:121–127.

    Article  Google Scholar 

  3. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003; 58:(Suppl 2):39–52.

    Article  Google Scholar 

  4. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med 2000; 342:868–874.

    Article  CAS  Google Scholar 

  5. O’Connor AR, Morgan WE. Radiological review of pneumothorax. BMJ 2005; 330:1493–1497.

    Article  Google Scholar 

  6. MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65:(Suppl 2):ii18–ii18ii 31.

    Article  Google Scholar 

  7. Lee LP, Lai MH, Chiu WK, Leung MW, Liu KK, Chan HB. Management of primary spontaneous pneumothorax in Chinese children. Hong Kong Med J 2010; 16:94–100.

    PubMed  CAS  Google Scholar 

  8. Chew R, Gerhardy B, Simpson G. Conservative versus invasive treatment of primar spontaneous pneumothorax: a retrospective cohort study. Jpn Assoc Acute Med J 2014; 10:1002.

    Google Scholar 

  9. Sousaa C, Neves J, Sab N, Goncalves F, Oliveira J, Reisa E. Spontaneous pneumothorax: a 5-year experience. J Clin Med Res 2011; 3:111–117.

    Google Scholar 

  10. Andrivet P, Djedaini K, Teboul JL, Brochard L, Dreyfuss D. Spontaneous pneumothorax: comparison of thoracic drainage vs immediate or delayed needle aspiration. Chest 1995; 108:335–339.

    Article  CAS  Google Scholar 

  11. Wojsyk-Banaszak I, Schoeneich N, Jończyk-Potoczna K, Henschke J, Breborowicz A. Analysis of incidence and clinical picture of pneumothorax in children. Pol Merkur Lekarski 2011; 31:335–339.

    PubMed  Google Scholar 

  12. Ferraro P, Beauchamp G, Lord F, Emond C, Bastien E. Spontaneous primary and secondary pneumothorax: a 10-year study of management alternatives. Can J Surg 1994; 37:197–202.

    PubMed  CAS  Google Scholar 

  13. Jones PM, Hewer RD, Wolfenden HD, Thomas PS. Subcutaneous emphysema associated with chest tube drainage. Respirology 2001; 6:87–89.

    Article  CAS  Google Scholar 

  14. Chee CB, Abisheganaden J, Yeo JK, Lee P, Huan PY, Poh SC, Wang YT Persistent air-leak in spontaneous pneumothorax − clinical course and outcome. Respir Med 1998; 92:757–761.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amr M. Shoukri.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Korraa, E.E., Madkour, A.M., Shoukri, A.M. et al. Outcome of patients with spontaneous pneumothorax admitted in Abbasia Chest Hospital. Egypt J Bronchol 10, 355–359 (2016). https://doi.org/10.4103/1687-8426.193646

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1687-8426.193646

Keywords

  • complications
  • outcome
  • primary spontaneous pneumothorax
  • secondary spontaneous pneumothorax