Spontaneous pneumothorax: pragmatic management and long-term outcome

We prospectively considered 65 patients admitted for a spontaneous pneumoth orax (SP) to describe the pragmatic management of SP, the first recurrence- free interval after medical therapeutic procedure and to specify the first recurrence risk factors over a 7-year period in these patients treated medi cally. The treatment options were observation alone (9%), needle aspiration (6%), small calibre chest tube (Pleurocatheter(R)) drainage (28%) or thoracic tub e drainage (49%), and pleurodesis with video-assisted thoracic surgery proc edure (8%). Duration of the drainage and length of hospital stay were short er in the Pleurocatheter(R) group than in the thoracic tube group (P<0.01). Among the 47 patients (72%) with a first SP and treated medically, nine pa tients (19%) had a first homolateral recurrence (FHR) during a mean follow- up of 84<plus/minus>13 months. Recurrence-free intervals ranged from 1 to 2 4 months (mean +/- SD: 9.3 +/-8.4 months). FHR cases were more frequent in the Pleurocatheter(R) group (P<0.04). Analysis of potential risk factors showed that the patients height and a pr evious homolateral SP episode are independent recurrence risk factors. (C) 2001 Harcourt Publishers Ltd.