Retrospective investigation of Spontaneous Pneumothorax in adult patients: An analysis of clinical Characteristics

Authors

  • Fahad Usman
  • Abdul Sallam Sajid
  • Asim Maqsood
  • Maira Arif
  • Tahir Mukhtar Sayed
  • Humaira Mubeen Afzal

Keywords:

Spontaneous Pneumothorax, Adults Patients, Risk Factor, Clinical Characteristics

Abstract

Background: Spontaneous pneumothorax (SP) typically manifests as persistent, intense, one-sided chest pain that worsens with deep breaths and adjustments in body position. It can manifest with breathlessness or a combination of breathlessness and chest pain. Objective: The objective of this study was to investigate spontaneous pneumothorax in adult patients. Methodology: This retrospective study was conducted on 104 spontaneous pneumothorax adults patients in the Department of Medicine, Shalamar Hospital, Lahore from January 2022 to September 2022. All individuals aged ≥18 years presented with spontaneous pneumothorax were included. Data regarding demographic characteristics, clinical details, radiological findings, and treatment approaches was collected from medical records. Results: The overall mean age was 44.6±8.2 years. Patients were distributed based on age group as follows: 42 (40.4%) in 18-35 years, 52 (50%) in 36-50 years, and 10 (9.6%) in 51-65 years. Spontaneous pneumothorax (SP) was more prevalent among males. Smoking emerged as a significant risk factor, with 48.1% of all cases having a history of smoking. The most frequent symptom associated with SP was dyspnea, often accompanied by unilateral chest pain. Tuberculosis was identified as the leading cause of SP. Moreover, tube thoracostomy successfully managed 85% of the cases. Conclusion: Spontaneous pneumothorax (SP) exhibited a higher prevalence among males and tended to occur more frequently during the third and fifth decades of life. Assessing the clinical profile of patients with SP was valuable in determining its underlying causes. Early screening for risk factors and identifying comorbidities played a crucial role in SP prevention. Keywords: Spontaneous Pneumothorax; Adults patients; Risk factors; Clinical Characteristics

Author Biographies

Fahad Usman

Department of Community Medicine, Sialkot Medical College, Sialkot - Pakistan

Abdul Sallam Sajid

Department of Medicine, Shalamar Hospital, Lahore - Pakistan

Asim Maqsood

Department of Medicine, Avicenna Medical College and Hospital, Lahore - Pakistan

Maira Arif

Islam Medical and Dental College, Sialkot – Pakistan

Tahir Mukhtar Sayed

Department of Medicine, Akhtar Saeed Medical College, Rawalpindi - Pakistan

Humaira Mubeen Afzal

Department of Medicine, Avicenna Medical College and Hospital, Lahore - Pakistan

References

Gopichand N, Oruganti S, Kasina P, Sathvika MV, Suvvari TK, Sree PC, et al. A study on etiology, risk factors, and clinical profle of spontaneous pneumothorax: Asingle‑center experience from South India. Indian J Med Spec 2022;11:11.

Louw EH, Shaw JA, Koegelenberg CF. New insights into spontaneous pneumothorax: A review. Afr J Thorac Crit Care Med 2021;27(1): DOI: 10.7196/ajtccm.2021.v27i1.054.

Hallifax R. Aetiology of Primary Spontaneous Pneumothorax. Journal of Clinical Medicine. 2022; 11(3):490. DOI:10.3390/jcm11030490

Light RW. Pneumothorax. In: Pleural diseases. 6th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2019. p. 363–495.

Onuki T, Ueda S, Yamaoka M, Sekiya Y, Yamada H, Kawakami N, et al. Primary and secondary spontaneous pneumothorax: prevalence, clinical features, and in-hospital mortality. Can Respir J. 2017;2017:1-8. DOI:10.1155/2017/6014967.

Hallifax RJ, Goldacre R, Landray MJ, Rahman NM, Goldacre MJ. Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016. JAMA. 2018;320(14):1471–1480. DOI:10.1001/jama.2018.14299.

Sharma A, Sharma A, Jaret P, Sarkar M, Sharma S. Clinical and etiological spectrum of spontaneous pneumothorax in adults in Sub-Himalayan: a prospective study at tertiary care institute. Int J Sci Rep. 2018;4(2):22-5 DOI: 10.18203/issn.2454-2156.IntJSciRep20180393.

Patil SV, Bhagwat RV, Mohite RV, Barphe SS. Clinical profile and treatment outcome of patients with spontaneous pneumothorax. Int J Res Med Sci. 2017;5:944-8. DOI: 10.18203/2320-6012.ijrms20170641.

Shaikh R, Janssen F, Vogt T. The progression of the tobacco epidemic in India on the national and regional level, 1998-2016. BMC Public Health. 2022;317. DOI:10.1186/s12889-021-12261-y.

Carson‐Chahhoud KV, Wakai A, Van Agteren JE, Smith BJ, McCabe G, Brinn MP, et al. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults. Cochrane Database of Systematic Reviews. 2017;(9).

Williams K, Oyetunji TA, Hsuing G, Hendrickson RJ, Lautz TB. Spontaneous pneumothorax in children: national management strategies and outcomes. J Laparoendosc Adv Surg Tech. 2018;28(2):218-22.

Nishizawa S, Tobino K, Murakami Y, Uchida K, Kawabata T, Ota H, et al. Mortality and prognostic factors for spontaneous pneumothorax in older adults. Plos one. 2013;18(9):e0291233.

Seguier-Lipszyc E, Elizur A, Klin B, Vaiman M, Lotan G. Management of primary spontaneous pneumothorax in children. Clin. Pediatr. 2011;50(9):797-802.

Patil SV, Bhagwat RV, Mohite RV, Barphe SS. Clinical profile and treatment outcome of patients with spontaneous pneumothorax. Int J Res Med Sci. 2017;5:944-8.

Pogorelić Z, Gudelj R, Bjelanović D, Jukić M, Elezović Baloević S, Glumac S, et al. Management of the pediatric spontaneous pneumothorax: the role of video-assisted thoracoscopic surgery. J Laparoendosc Adv Surg Tech. 2020;30(5):569-75.

Saito Y, Suzuki Y, Demura R, Kawai H. The outcome and risk factors for recurrence and extended hospitalization of secondary spontaneous pneumothorax. Surg Today. 2018; 48: 320–324.

Nishimoto K, Fujisawa T, Yoshimura K, Enomoto Y, Enomoto N, Nakamura Y, et al. The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis. Respirology. 2018;23(5):519-25.

Igai H, Kamiyoshihara M, Ibe T, Kawatani N, Shimizu K. Surgical treatment for elderly patients with secondary spontaneous pneumothorax. Gen Thorac Cardiovasc Surg. 2016; 64: 267–272.

Olesen WH, Titlestad IL, Andersen PE, Lindahl-Jacobsen R, Licht PB. Incidence of primary spontaneous pneumothorax: a validated, register-based nationwide study. ERJ Open Res. 2019; 5: 00022–2019.

Takahashi F, Takihara T, Nakamura N, Horio Y, Enokida K, Hayama N, et al. Etiology and prognosis of spontaneous pneumothorax in the elderly. Geriatr Gerontol Int. 2020;20:878-84. DOI: 10.1111/ggi.13996.

Huang YH, Chang PY, Wong KS, Chang CJ, Lai JY, Chen JC. An age-stratified longitudinal study of primary spontaneous pneumothorax. J Adolesc Health. 2017;61(4):527-32.

Sevinc S, Kaya SO, Akcam TI, Ceylan KC, Ozturk O, Susam S. Prolonged air leakage in secondary spontaneous pneumothorax: is proportion of emphysema important?. Clin Respir J. 2017 ;11(6):833-8

Akamine T, Kometani T, Hashinokuchi A, Akamine S, Shikada Y, Wataya H. Interpleural distance predicts persistent air leak after initial primary spontaneous pneumothorax. J Thorac Dis. 2020;12(5):2228–35.

Nagata S, Omasa M, Tokushige K, Nakanishi T, Motoyama H. Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients. Interact Cardiovasc Thorac Surg. 2020;30(2):263–8.

Kim D, Jung B, Jang BH, Chung SH, Lee YJ, Ha IH. Epidemiology and medical service use for spontaneous pneumothorax: A 12-year study using nationwide cohort data in Korea. BMJ Open.2019;9(10):e028624.

Walker SP, Bibby AC, Halford P, Stadon L, White P, Maskell NA. Recurrence rates in primary spontaneous pneumothorax: A systematic review and meta-analysis. Eur Respir J. 2018;52(3):1800864

Daemen JH, Lozekoot PW, Maessen JG, Gronenschild MH, Bootsma GP, Hulsewé KW, et al. Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: A systematic review and meta-analysis. Eur J Cardiothorac Surg. 2019;56(5):819–829 .

Fujiwara T, Tanaka K, Toyoda T, Inage T, Sakairi Y, Ishibashi F, et al. Risk factors of postoperative recurrence of primary spontaneous pneumothorax. J Thorac Dis. 2020; 12(11): 6458.

Hung WT, Chen HM, Wu CH, Hsu WM, Lin JW, Chen JS. Recurrence rate and risk factors for recurrence after thoracoscopic surgery for primary spontaneous pneumothorax: A nationwide population-based study. J Formos Med Assoc. 2021;120(10):1890–6.

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Published

2023-06-02

How to Cite

Fahad Usman, Abdul Sallam Sajid, Asim Maqsood, Maira Arif, Tahir Mukhtar Sayed, & Humaira Mubeen Afzal. (2023). Retrospective investigation of Spontaneous Pneumothorax in adult patients: An analysis of clinical Characteristics. Pakistan Journal of Chest Medicine, 29(2), 141–147. Retrieved from https://pjcm.net/index.php/pjcm/article/view/797

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