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28.01.2020 | Original Article | Ausgabe 3/2020

Pediatric Surgery International 3/2020

Primary spontaneous pneumothorax in children: factors predicting recurrence and contralateral occurrence

Zeitschrift:
Pediatric Surgery International > Ausgabe 3/2020
Autoren:
Glenn Yang Han Ng, Shireen Anne Nah, Oon Hoe Teoh, Lin Yin Ong
Wichtige Hinweise
Part of the results of this study was presented at the 51st Annual Meeting of the Pacific Association of Pediatric Surgeons in Sapporo, Japan, on 15th May 2018.

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Abstract

Background

The risk factors for recurrence in primary spontaneous pneumothorax (PSP) in children are not well known. We aimed to identify possible risk factors, and to evaluate the utility of computerised tomography (CT) scans in predicting future episodes.

Methods

We reviewed children aged < 18 years admitted to our institution for PSP from 2008 to 2017, excluding those with malignancies. Basic demographic data were extracted. Clinical data collected include pneumothorax laterality, CT results, treatment protocols and recurrences.

Results

63 patients were included, 19 (30.2%) of whom had CT scans. A total of 41 surgeries were performed. The median (interquartile range) age was 15.4 years (14.9–15.9), and body-mass index was 17.9 kg/m2 (15.8–19.3). 56 (88.9%) patients were male. Median follow-up duration was 19.8 months (11.6–35.9). Multivariate logistic regression analyses identified surgery in the first episode as a predictor for a subsequent contralateral occurrence (odds ratio [95% confidence interval] 32.026 [1.685–608.518], p = 0.021). No predictors for ipsilateral recurrence were found. CT scans were 76.5% sensitive for bleb detection, and predicted poorly for occurrence (positive predictive value 14.3%, likelihood ratio 1.1).

Conclusion

This is the first study demonstrating that surgery at first presentation appears to predict for occurrence of PSP on the contralateral lung. CT appears to be ineffective in detecting blebs and predicting PSP occurrence.

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