October 31, 2018
Chronic lung disease was prevalent, affecting >60% of individuals with spontaneous pneumothorax.Hospitalization for spontaneous pneumothorax has increased significantly since 1968, according to a study recently published in the Journal of the American Medical Association. In addition, readmission for spontaneous pneumothorax showed variations by age and chronic lung disease but showed similarities by sex.
This population-based study included 170,929 hospitalizations (73.0% men; median age, 44 years) for spontaneous pneumothorax. For those aged ≥15 years, spontaneous pneumothorax admissions in 2016 occurred at a rate of 14.1 per 100,000 (95% CI, 13.7-14.4). This represented an increase from 9.1 admissions per 100,000 (95% CI, 8.1-10.1) in 1968. In addition, the admission rate per 100,000 population was higher in men compared with women (20.8; 95% CI, 20.2-21.4 vs 7.6; 95% CI, 7.2-7.9).
Chronic lung disease was prevalent, affecting 60.8% (95% CI, 59.5%-62.0%) of individuals with spontaneous pneumothorax. A rise in repeat admissions could be partially responsible for the cumulative increase in hospitalizations. However, first-time hospitalizations for spontaneous pneumothorax also increased annually from 1968 to 2016 in women ≥65 years old (4.08 annual percentage change; 95% CI, 3.33-4.82; P <.001).
Recurrence in ≤5 years was similar with respect to sex, but there was variation by age and chronic lung disease status. Men showed a 5-year recurrence rate of 25.5% (95% CI, 25.1%-25.9%), while the rate was 26.0% (95% CI, 25.3%-26.7%) in women. Within 1 year, the recurrence rate was 18.8% (95% CI, 18.4%-19.1%) in men and 19.5% (95% CI, 18.9%-20.1%) in women. Readmission was also more likely in individuals whose first spontaneous pneumothorax occurred after 2008 compared with before 2008.
Hospital admissions and readmissions for spontaneous pneumothorax were the primary outcomes for this study. Researchers employed record-linkage to identify comorbidities and repeat admissions, and Cox proportional hazards regression and analysis of time-to-failure were used to examine risk factors for repeat admissions.
The researchers concluded that “[t]his study provides contemporary information regarding the trends in incidence and recurrence of inpatient-treated spontaneous pneumothorax.”
Disclosures: Dr Landray reports receiving financial contributions from Boehringer Ingelheim, the Medicines Company, UK Biobank, Merck, and the British Heart Foundation.
Reference
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.
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