TY - JOUR T1 - Journal club JF - Thorax JO - Thorax SP - 1132 LP - 1132 DO - 10.1136/thoraxjnl-2020-216408 VL - 75 IS - 12 AU - Natasha Emily Hough Y1 - 2020/12/01 UR - http://thorax.bmj.com/content/75/12/1132.abstract N2 - The optimum management of primary spontaneous pneumothorax remains controversial. Hallifax et al (Lancet 2020;396:39) performed a multicentre, open-label randomised controlled trial of 236 patients from 24 centres comparing ambulatory management of primary spontaneous pneumothorax with standard care (as per British Thoracic Society (BTS) guidelines). Patients were enrolled if they had a symptomatic pneumothorax (≥2 cm) and were assigned randomly to either insertion of an 8-French ambulatory device (n=117) or standard care (n=119). Primary outcome was total length of hospital stay up to 30 days postrandomisation. Median hospital stay in the first 30 days was 0 (0–3) days in those who had ambulatory care compared with 4 (0–8) days in standard care, with a median difference 2 days (95% CI 1 to 3, p<0.0001). Readmission rates were similar between groups. Time until successful completion of treatment was longer in the ambulatory care group (3 (1–6) days) vs standard care (2 (0–6) days), p=0.0040. The adverse event rate was high (ambulatory=64/117, standard care=46/119). All 14 serious adverse events occurred in the ambulatory care arm and required readmission to hospital. The authors conclude that ambulatory management of primary spontaneous pneumothorax reduces the duration of hospital admission and is an … ER -