Characteristics of adult patients with spontaneous pneumothorax in the emergency department: A case series

Abstract

Introduction: To describe demographic characteristics and clinical presentation of patients with paroxysmal spontaneous pneumothorax (SP) in the emergency department and to determine differences between primary SP (PSP) and secondary SP (SSP).
Material and Method: All consecutive adult patients who were diagnosed to have SP in the ED within one-year period were enrolled in this retrospective, descriptive study. The charts were reviewed regarding the age, gender, complaints on admission, clinical sign, treatment in emergency department, risk factors for pneumothorax such smoking, effort, family history, drug use, chronic obstructive pulmonary disease, pulmonary infections and acquired immune deficiency syndrome.
Results: A sixty cases (56 males, 93.3%) diagnosed to have SP were enrolled. The mean age was 36.2±16.8 (range: 18 to 76). Seven (%11.7) patients had recurrent pneumothorax. 43 (%71.7) patients used to smoke. Dyspnea was the most common complaint reported by the patients (n=56, 93.3%), followed by chest discomfort and pain (n=39, 65.0%), and palpitation (n=15, 25.0%). Decreased breath sounds over the affected lung were seen in 54 (90.0%) patients, not to hear breath sounds over the affecting lung were determined in 18 (30.0%), tachycardia was established in 13 (21.7%), hyperresonance was seen in one (1.7%) and bradicardia was determined in one (1.7%). When investigated treatments applied for patients; chest tube thoracostomy for 41 (68.3%) patients, catheter aspiration for 3 (5%) patients and observation with concomitant oxygen administration for 15 (25%). PSP were shown in 42 (70.0 %) patients whereas SSP were revealed in 18 (30.0%) patients. Patients with PSP were younger than SSP (p<0.001).
Conclusion: SP is common in young and male patients. Smoking is an important risk factor for SP. PSP is seen in younger patients than SSP.