Predictors of Contralateral Recurrence in Patients With Primary Spontaneous Pneumothorax.

Area of Science:

• Thoracic surgery
• Pulmonology
• Medical imaging

Background:

• Recurrence of primary spontaneous pneumothorax (PSP) leads to hospital readmissions and increased healthcare expenses.
• Identifying predictors for PSP recurrence can help mitigate these burdens.

Purpose of the Study:

• To investigate the outcomes of asymptomatic contralateral bullae in patients with ipsilateral PSP.
• To identify risk factors associated with contralateral pneumothorax incidence.

Main Methods:

• Retrospective analysis of 184 PSP cases (ages 18-50) treated with thoracoscopic bullectomy from January 2014 to May 2023.
• Exclusion criteria included patients over 50, traumatic pneumothorax, and bilateral PSP.

Main Results:

• Contralateral recurrence occurred in 14.3% of patients.
• Significant predictors for recurrence included contralateral bullae presence (p=0.002), bullae number (p=0.003), and affected hemithorax side (p=0.036).
• Initial PSP side was a significant predictor (2.8x higher likelihood, p=0.046), while increasing bullae number correlated with decreased odds of contralateral pneumothorax (44% decrease, p=0.038).

Conclusions:

• Patients with PSP and contralateral bullae on imaging require close follow-up.
• Informing patients about recurrence risks is essential for preventing complications.