Acute pneumothorax: a comparison of elderly with younger patients

This report compares the presentations and outcome of pneumothorax in 11 patients aged over 65 with 15 patients aged 20-35 years. Information was retrospectively collected from the charts regarding modes of presentation and the course of the illness. A questionnaire was sent to the general practitioners of the older group asking about the long-term outcome relating to functional status. Older patients were more likely than younger to present primarily with dyspnoea. The classical symptom of acute onset of pleuritic chest pain was present in ten of the 15 younger patients but in only two of the older patients. There were also statistically significant associations of the elderly patients with the following: radiological evidence of pre-existing lung disease; absence of pleuritic chest pain on admission; atypical or absent pain; a major delay from symptom onset to presentation; the diagnosis being clinically missed prior to chest radiography; and prolonged hospitalization. Nine of the 11 elderly patients were eventually independent at home.