Spontaneous pneumothorax: Suggested etiology and comparison of treatment methods

doi:10.1016/0002-9610(64)90030-3

The American Journal of Surgery

Volume 108, Issue 6, December 1964, Pages 772-776

https://doi.org/10.1016/0002-9610(64)90030-3 Get rights and content

Abstract

One hundred ninety-five cases of spontaneous pneumothorax were reviewed as treated during a five year period at the United States Army Tripler General Hospital. Sixty-two per cent of the patients were treated primarily with an intercostal tube connected to a water-seal bottle. Twenty-one per cent of the patients were treated primarily with bed rest. Twelve per cent of the patients required an open thoracotomy either for recurrent pneumothoraces or a continuing bronchopleural fistula.

In reviewing the cases of spontaneous pneumothorax, it is found to be more common in the tall, thin young male. A theory for the development of pulmonary blebs in these patients has been suggested.

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Cited by (89)

Risk factors for recurrent spontaneous pneumothorax: A population level analysis
2022, American Journal of Surgery
Citation Excerpt :
Comorbidities included obesity (ICD-9-CM 278.0–278.1, V853.5-V853.4), active tobacco use (ICD-9-CM 305.1, V158.2, 989.94), chronic obstructive pulmonary disease (ICD-9-CM 492.8, 496), and lung cancer (ICD-9-CM 162.0–163.9). These comorbidities were included given previous studies which had indicated a relationship between these conditions and spontaneous pneumothorax.7,8,13,14 We also examined the role of interventions in the initial episode of spontaneous pneumothorax.
We sought to determine the rate and risk factors of recurrent spontaneous pneumothorax in a diverse population.
Cohort study using the California Public Discharge Data file (1995–2010). We identified patients with first-time spontaneous pneumothorax. The primary outcome was recurrent pneumothorax. Associations with clinical, patient, and hospital characteristics were assessed using Cox regression analysis.
Among 14,609 patients with a first-time episode of spontaneous pneumothorax, 26.2% developed a recurrence. Risk factors included age <35 (Hazard Ratio [HR] 1.24 95%-Confidence Interval [CI] 1.14–1.36), Asian race (HR 1.24, CI 1.13–1.37), and tube thoracostomy (HR 1.2, CI 1.15–1.31). Mechancial pleurodesis (HR 0.37 CI 0.31–0.45) was superior to chemical pleurodesis (HR 0.71 CI 0.58–0.86) in reducing recurrence risk.
The risk of recurrent pneumothorax is greatest in patients age <35, Asians, and those requiring a tube thoracostomy. The risks of operative intervention should be balanced against patient risk for recurrence.
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^☆: Winner of the 1964 Honolulu Surgical Society Essay Award.

^†: Present address: McDonald Army Hospital, Fort Eustis, Virginia.

¹: From the General Surgery Service, Department of Surgery, U. S. Army Tripler General Hospital, Honolulu, Hawaii.

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Scientific paperSpontaneous pneumothorax: Suggested etiology and comparison of treatment methods☆

Abstract

J. Thoracic Surg.

Dis. Chest

J. Thoracic & Cardiovas. Surg.

Scientific paper
Spontaneous pneumothorax: Suggested etiology and comparison of treatment methods☆