Abstract
To examine whether it is possible to predict the recurrence of primary spontaneous pneumothorax, we analyzed 218 cases of primary spontaneous pneumothorax treated with conservative therapy at the first episode of pneumothorax, dividing the cases into a recurrent group (74 cases) and non-recurrent group (144 cases). Patient characteristics: the average age was 24.5 years old, male/female 199/19 cases, history of pneumothorax on the contralateral side yes/no 21/197 cases, smoking habit yes/no/unknown 93/75/50 cases. Cases under 24 y.o. (recurrence rate: 42%), a female gender (63%), history of pneumothorax on the contralateral side (57%), and a non-smoker status (55%) were associated with a significantly higher recurrence rate on univariate analysis. On multivariate analysis, a non-smoker status was an independent predictive factor of recurrence (p=0.006, odds ratio: 2.410). Based on the above findings, we think that non-smoking patients with initial primary spontaneous pneumothorax, after consideration of their wishes, can be treated surgically, because they have a high risk of recurrence. Moreover, we infer that there is difference between smokers and non-smokers regarding the mechanism of how spontaneous pneumothorax occurs.
