Abstract
Primary Spontaneous Pneumothorax (PSP) recurrence rates vary widely in the published literature, with limited data describing the factors that influence recurrence. The aims of this systematic review were to determine an estimation of PSP recurrence rates and describe risk factors for recurrence.
A systematic review was conducted of all studies reporting PSP recurrence. Electronic searches were performed to identify English language publications of randomised trials and observational studies. The population was adults with PSP, who underwent conservative management, pleural aspiration or chest drainage. The outcome of interest was recurrence. Articles were screened, and data extracted from eligible studies by two reviewers.
Of 3607 identified studies, 29 were eligible for inclusion, comprising 13,548 patients. Pooled 1-year and overall recurrence rates were 29.0%(95% CI 20.9% to 37.0%) and 32.1%(95% CI 27.0% to 37.2%) respectively. Female gender was associated with increased recurrence, OR 3.0(95% CI 1.24 to 7.41), whilst smoking cessation was associated with fourfold decrease in risk, OR 0.26(95% CI 0.10 to 0.63). I2 for random effects meta-analysis was 94%(p<0.0001) reflecting high heterogeneity between studies.
This systematic review demonstrates a 32% PSP recurrence rate, with greatest risk in the first year. Female gender was associated with higher risk, suggesting possible gender-specific pathophysiology.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Walker has nothing to disclose.
Conflict of interest: Dr. Bibby has nothing to disclose.
Conflict of interest: Dr. Halford has nothing to disclose.
Conflict of interest: Dr. Stadon has nothing to disclose.
Conflict of interest: Dr. White has nothing to disclose.
Conflict of interest: Dr. Maskell has nothing to disclose.
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