This report compares the presentations and outcome of pneumothorax in
11 patients aged over 65 with 15 patients aged 20-35 years. Informatio
n was retrospectively collected from the charts regarding modes of pre
sentation and the course of the illness. A questionnaire was sent to t
he general practitioners of the older group asking about the long-term
outcome relating to functional status. Older patients were more likel
y than younger to present primarily with dyspnoea. The classical sympt
om of acute onset of pleuritic chest pain was present in ten of the 15
younger patients but in only two of the older patients. There were al
so statistically significant associations of the elderly patients with
the following: radiological evidence of pre-existing lung disease; ab
sence of pleuritic chest pain on admission; atypical or absent pain; a
major delay from symptom onset to presentation; the diagnosis being c
linically missed prior to chest radiography; and prolonged hospitaliza
tion. Nine of the 11 elderly patients were eventually independent at h
ome.