Risk Factors for Recurrence of Primary Spontaneous Pneumothorax in Adolescents

The recurrence of primary spontaneous pneumothorax (PSP) is common among adolescents. This study investigated the recurrence rate and the risk factors of PSP in adolescents.

A total of 103 (aged 12-18 years) adolescents who presented with PSP were included. The exclusion criterion was iatrogenic or secondary pneumothorax. Patients were classified into 2 groups: the nonrecurrence group and the recurrence group.

There were 61 patients in the nonrecurrence group and 42 patients in the recurrence group. The recurrence rate was 45.8% with supplemental oxygen, 47.7% with pigtail drainage, and 28.6% with video-assisted thoracic surgery (VATS). The recurrence rates in patients who did not undergo VATS and those who did undergo VATS were 47.1% and 28.6%, respectively. In a comparison of the nonrecurrence, ipsilateral recurrence, and contralateral recurrence groups, the percentage of patients in the ipsilateral recurrence group who underwent surgery was significantly lower, and the percentage of patients with bullae found by computed tomography was significantly higher in the contralateral recurrence group. The incidence of pleural abnormalities was also found to be higher in the contralateral recurrence group.

The recurrence rate of PSP in our study was 40.8% and higher in male patients. Surgery after the first episode of PSP appears to significantly reduce the risk of ipsilateral recurrence. Furthermore, if bullae are revealed by computed tomography or pleural abnormalities are revealed by chest radiograph, the incidence of subsequent contralateral recurrence may be higher.