Recurrence of primary spontaneous pneumothorax: Associated factors
Introduction: Determining the risk of recurrence of primary spontaneous pneumothorax is challenging. The objective of this study was to develop a risk assessment model to predict the probability of recurrence in patients with spontaneous pneumothorax. Methods: A retrospective study was performed of...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2022-07-01
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| Series: | Pulmonology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531043720301379 |
| _version_ | 1811231415016095744 |
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| author | V. Riveiro-Blanco C. Pou-Álvarez L. Ferreiro M.E. Toubes J. Quiroga-Martínez J. Suárez-Antelo J.M. García-Prim J.E. Rivo-Vázquez R. Castro-Calvo F.J. González-Barcala F. Gude L. Valdés |
| author_facet | V. Riveiro-Blanco C. Pou-Álvarez L. Ferreiro M.E. Toubes J. Quiroga-Martínez J. Suárez-Antelo J.M. García-Prim J.E. Rivo-Vázquez R. Castro-Calvo F.J. González-Barcala F. Gude L. Valdés |
| author_sort | V. Riveiro-Blanco |
| collection | DOAJ |
| description | Introduction: Determining the risk of recurrence of primary spontaneous pneumothorax is challenging. The objective of this study was to develop a risk assessment model to predict the probability of recurrence in patients with spontaneous pneumothorax. Methods: A retrospective study was performed of all episodes of pneumothorax diagnosed in the last 12 years in a hospital, in patients not initially submitted to surgery. Logistic regression was used to estimate the probability of recurrence. Based on a set of variables, a predictive model was built with its corresponding ROC curve to determine its discrimination power and diagnostic precision. Results: Of the 253 patients included, 128 (50.6%) experienced recurrence (37% within the first year). Recurrence was detected within 110 days in 25% of patients. The median of time to recurrence for the whole population was 1120 days. The presence of blebs/bullae was found to be a risk factor of recurrence (OR: 5.34; 95% CI: 2.81–10.23; p = 0.000), whereas chest drainage exerted protective effect (OR: 0.19; 95% CI: 0.08–0.40; p = 0.000). The variables included in the regression model constructed were hemoglobin and leukocyte count in blood, treatment received, and presence of blebs/bullae, with a fair discriminative power to predict recurrence [AUC = 0.778 (95% CI: 0.721–0.835)]. Conclusion: The overall recurrence rate was high and was associated with the presence of blebs/bullae, failure to perform an active intervention (chest drainage) and low levels of hemoglobin and leukocytes in blood. Recurrence rarely occurs later than three years after the first episode. Once validated, this precision model could be useful to guide therapeutic decisions. |
| first_indexed | 2024-04-12T10:45:00Z |
| format | Article |
| id | doaj.art-9486f53c8b9e4c38880ec045b14f7b36 |
| institution | Directory Open Access Journal |
| issn | 2531-0437 |
| language | English |
| last_indexed | 2024-04-12T10:45:00Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Pulmonology |
| spelling | doaj.art-9486f53c8b9e4c38880ec045b14f7b362022-12-22T03:36:29ZengElsevier EspañaPulmonology2531-04372022-07-01284276283Recurrence of primary spontaneous pneumothorax: Associated factorsV. Riveiro-Blanco0C. Pou-Álvarez1L. Ferreiro2M.E. Toubes3J. Quiroga-Martínez4J. Suárez-Antelo5J.M. García-Prim6J.E. Rivo-Vázquez7R. Castro-Calvo8F.J. González-Barcala9F. Gude10L. Valdés11Pneumology Department, University Hospital Complex of Santiago de Compostela, Spain; Corresponding author.Pneumology Department, University Hospital Complex of Santiago de Compostela, SpainPneumology Department, University Hospital Complex of Santiago de Compostela, Spain; Pneumology Interdisciplinary Research Group, Santiago de Compostela Health Research Institute (IDIS), SpainPneumology Department, University Hospital Complex of Santiago de Compostela, SpainThoracic Surgery Department, SpainPneumology Department, University Hospital Complex of Santiago de Compostela, SpainThoracic Surgery Department, SpainThoracic Surgery Department, SpainAdmission Service, SpainPneumology Department, University Hospital Complex of Santiago de Compostela, Spain; Pneumology Interdisciplinary Research Group, Santiago de Compostela Health Research Institute (IDIS), SpainEpidemiology Department, University Hospital Complex of Santiago de Compostela, Spain; Research Group on Epidemiology of Common Diseases, Santiago de Compostela Health Research Institute (IDIS), SpainPneumology Department, University Hospital Complex of Santiago de Compostela, Spain; Pneumology Interdisciplinary Research Group, Santiago de Compostela Health Research Institute (IDIS), SpainIntroduction: Determining the risk of recurrence of primary spontaneous pneumothorax is challenging. The objective of this study was to develop a risk assessment model to predict the probability of recurrence in patients with spontaneous pneumothorax. Methods: A retrospective study was performed of all episodes of pneumothorax diagnosed in the last 12 years in a hospital, in patients not initially submitted to surgery. Logistic regression was used to estimate the probability of recurrence. Based on a set of variables, a predictive model was built with its corresponding ROC curve to determine its discrimination power and diagnostic precision. Results: Of the 253 patients included, 128 (50.6%) experienced recurrence (37% within the first year). Recurrence was detected within 110 days in 25% of patients. The median of time to recurrence for the whole population was 1120 days. The presence of blebs/bullae was found to be a risk factor of recurrence (OR: 5.34; 95% CI: 2.81–10.23; p = 0.000), whereas chest drainage exerted protective effect (OR: 0.19; 95% CI: 0.08–0.40; p = 0.000). The variables included in the regression model constructed were hemoglobin and leukocyte count in blood, treatment received, and presence of blebs/bullae, with a fair discriminative power to predict recurrence [AUC = 0.778 (95% CI: 0.721–0.835)]. Conclusion: The overall recurrence rate was high and was associated with the presence of blebs/bullae, failure to perform an active intervention (chest drainage) and low levels of hemoglobin and leukocytes in blood. Recurrence rarely occurs later than three years after the first episode. Once validated, this precision model could be useful to guide therapeutic decisions.http://www.sciencedirect.com/science/article/pii/S2531043720301379Primary spontaneous pneumothoraxRecurrenceLogistic regression analysis |
| spellingShingle | V. Riveiro-Blanco C. Pou-Álvarez L. Ferreiro M.E. Toubes J. Quiroga-Martínez J. Suárez-Antelo J.M. García-Prim J.E. Rivo-Vázquez R. Castro-Calvo F.J. González-Barcala F. Gude L. Valdés Recurrence of primary spontaneous pneumothorax: Associated factors Pulmonology Primary spontaneous pneumothorax Recurrence Logistic regression analysis |
| title | Recurrence of primary spontaneous pneumothorax: Associated factors |
| title_full | Recurrence of primary spontaneous pneumothorax: Associated factors |
| title_fullStr | Recurrence of primary spontaneous pneumothorax: Associated factors |
| title_full_unstemmed | Recurrence of primary spontaneous pneumothorax: Associated factors |
| title_short | Recurrence of primary spontaneous pneumothorax: Associated factors |
| title_sort | recurrence of primary spontaneous pneumothorax associated factors |
| topic | Primary spontaneous pneumothorax Recurrence Logistic regression analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2531043720301379 |
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