Demographics, clinical characteristics, and recurrence rate of patients with primary spontaneous pneumothorax at a tertiary care center in Qatar

Adeel Ahmad Khan; Muhammad Zahid; Mousa Ahmad Alhiyari; Abdulrahman Ahmad Al-Andulmalek; Unwam Ekpuk Jumbo; Mohammad Naser Kloub; Muhammad Muslim; Muhammad Naeem; Zohaib Yousaf; Rashid Mazhar; Muhammad Sharif

doi:10.5339/qmj.2022.56

Demographics, clinical characteristics, and recurrence rate of patients with primary spontaneous pneumothorax at a tertiary care center in Qatar

Qatar Med J. 2022 Nov 16;2022(4):56. doi: 10.5339/qmj.2022.56. eCollection 2022.

Authors

Affiliations

¹ Department of Medicine, Hamad Medical Corporation, Doha, Qatar Email & ORCID ID: adeel_1026@yahoo.com & https://orcid.org/0000-0003-1583-1539.
² Assistant Professor, Weill Cornell Medicine-Qatar.
³ Thoracic Surgery Department, Hamad Medical Corporation, Doha, Qatar.
⁴ Clinical Instructor, Weill Cornell Medicine-Qatar.

Abstract

Introduction: Primary spontaneous pneumothorax (PSP) is a common medical emergency. Its treatment includes simple observation, needle thoracentesis, pleural catheter, video-assisted thoracoscopy (VATS), and open surgery. We aimed to establish the demographic, clinical characteristics, and 12-month recurrence rate of patients with PSP in four hospitals of the Hamad Medical Corporation, Qatar.

Materials and methods: We conducted a retrospective analysis of patients >14 years old who were admitted with PSP from January 1, 2017 to December 31, 2019. The patients were followed up for 12 months for the recurrence of PSP.

Results: Out of 246 patients enrolled in this study, 223 (90.7%) were males and 23 (9.3%) were females. Their mean age was 29.1 ± 9.59 years and their mean body mass index (BMI) was 21.7 ± 4.22 kg/m². Of these, 123 (51.2%) patients were smokers. Chest pain was the most common presenting complaint (82.5%). A total of 59 (23.98%) patients had a small pneumothorax, whereas 187 (76.01%) patients had a large pneumothorax. Among the patients with small pneumothorax, 16 (28.33%) were managed through observation alone, 2 (3.33%) required needle aspiration, 15 (25%) required pleural catheter insertion, and 26 (44.06%) underwent surgical intervention for management. Out of 187 patients with large pneumothorax, 16 (8.6%) were managed through observation, 7 (3.76%) required needle aspiration, 73 (38.1%) required pleural catheter insertion, and 91 (48.6%) underwent surgery. During the 12-month follow-up, 58 patients were lost to follow-up and 5 patients (5/188; 2.66%) presented with a recurrence of PSP. Out of 108 patients who underwent VATS, 2 (1.85%) had a recurrence of PSP.

Conclusion: PSP is more common in males than in females, with a tendency for younger age onset. The recurrence rate of PSP in our study was 2.66%. Furthermore, the recurrence rate in our patients who underwent VATS was 1.85%. Prospective studies are warranted to compare the success rates of different treatment interventions.

Keywords: Pneumothorax; Primary Spontaneous Pneumothorax; Recurrence; VATS; Video-Assisted Thoracoscopic Surgery.