Background
Studies to date have not identified any reliable predictors for recurrence of primary
spontaneous pneumothorax (PSP) on plain chest radiograph (CXR). The aim of this study
was to assess whether abnormalities on CXR at first presentation of PSP can be used
to predict recurrence of PSP.
Method
The study included all patients admitted to The Canberra Hospital between 1998 and
2004. CXRs taken at initial presentation were reviewed retrospectively by an independent
radiologist. Radiological abnormalities on CXR included: pleural thickening: blebs/bullae;
pleural irregularities and pleural adhesions.
Results
One hundred patients were followed up for a mean duration of 57 months. The total
rate of recurrence was 54%. Multivariate analysis found that the presence of an abnormality
(irrespective of the type) increased the likelihood of recurrence and the risk of
recurrence increased with each additional abnormality. Patients having one, two and
three or more abnormalities were 3.0 (95% CI = 2.09, 3.91, p = 0.018), 5.3 (95% CI = 4.47, 6.13, p < 0.001) and 12.6 (95% CI = 11.57, 13.63, p < 0.001) times more likely to develop recurrence respectively.
Conclusion
In view of these results we now offer surgical treatment at first presentation PSP
in patients in whom we identify two or more radiological abnormalities on CXR.
Keywords
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Article info
Publication history
Accepted:
June 7,
2010
Received in revised form:
May 20,
2010
Received:
December 30,
2009
Identification
Copyright
© 2010 Published by Elsevier Inc. All rights reserved.
