Figures
- FIGURE 1
Flowchart showing the selection of primary spontaneous pneumothorax (PSP) patients in the national cohort. DNPR: Danish National Patient Registry; PTX: pneumothorax; SSP: secondary spontaneous pneumothorax.
- FIGURE 2
Incidence rate (IR) per 100 000 by age, overall and divided by sex.
- FIGURE 3
Incidence rate (IR) per 100 000 per year, overall and divided by sex.
Tables
- TABLE 1
Explanation of how each diagnosis was assigned during the systematic read-through
Diagnosis Criteria Spontaneous PTX Occurring with no apparent cause with or without tension
PSP: occurring in otherwise healthy individuals
SSP: occurring in patients with pre-existing lung-disorder
We assigned tension PTX diagnosis if there was evidence in the chart
both clinically and by chest radiography to support this diagnosis.PSP SSP Traumatic PTX Occurring as a direct result of trauma, including haemothorax Iatrogenic PTX Occurring unintentionally as a direct result of treatment, examination or surgery performed on the patient Perinatal/congenital PTX Occurring in relation to child birth or as a direct result of congenital disorders Isolated pneumomediastinum Typically occurring after extreme coughing or giving birth Thoracentesis Surgical puncture and drainage of the thoracic cavity, either diagnostic or as treatment Empyema A condition where pus collects in the pleural cavity Misclassification Suspected PTX; however, this was disproved but the diagnosis was maintained and reported to the national database by mistake No apparent reason for PTX Patients where no apparent reason for their PTX diagnosis was identified, despite thorough examination of all charts from the year 2000 onwards
Probably a PTX incident prior to the year 2000 or possibly misclassificationPTX: Pneumothorax; PSP: primary spontaneous pneumothorax; SSP: secondary spontaneous pneumothorax.
- TABLE 2
Pneumothorax (PTX) diagnoses in the validation population
PTX diagnosis (ICD code) ICD diagnosis ICD diagnosis applied originally ICD diagnosis after re-evaluation Spontaneous PTX With tension (J93.0) 17 256 Without tension (J93.1) 491 666 Iatrogenic PTX Post-surgery (J95.8A) 14 117 Iatrogenic (T81.2) 0 67 Traumatic PTX (S.27.0) 476 490 Other kinds of PTX (J93.8) 15 0 Unspecified PTX (J93.9) 599 0 Misclassification 0 36 ICD: International Classification of Diseases.
- TABLE 3
Incidence rates (IRs) per 100 000 individuals of primary spontaneous pneumothorax in Denmark overall and stratified by sex
Variables Overall Female Male Patients IR (95% CI) Patients IR (95% CI) Patients IR (95% CI) Age group 0–10 years 0 0 0 0 0 0 11–15 years 36 2.1 (1.5–2.9) 2 0.2 (0.1–0.8) 34 3.9 (2.8–5.5) 16–20 years 278 15.6 (9.5–25.6) 22 2.5 (1.6–3.8) 256 28.1 (24.9–31.8) 21–25 years 242 14.2 (8.4–23.9) 28 3.3 (2.3–4.8) 214 24.7 (21.6–28.2) 26–30 years 182 11.5 (6.5–20.5) 28 3.6 (2.5–5.2) 154 19.3 (16.5–22.6) 31–35 years 166 9.6 (5.1–18.1) 36 4.2 (3.0–5.8) 130 15.0 (12.6–17.8) 36–40 years 124 6.5 (3.0–14.0) 34 3.5 (2.5–4.9) 90 9.3 (7.6–11.4) Overall 1028 7.3 (6.9–7.8) 150 2.2 (1.9–2.6) 878 12.3 (11.5–13.1) Year 2009–2010 168 6.0 (5.2–6.9) 26 1.9 (1.3–2.8) 142 10.0 (8.5–11.8) 2010–2011 196 7.0 (6.1–8.1) 20 1.4 (0.9–2.2) 176 12.3 (10.6–14.3) 2011–2012 198 7.1 (6.2–8.2) 38 2.8 (2.0–3.8) 160 11.2 (9.6–13.1) 2012–2013 248 8.7 (7.7–9.6) 26 1.9 (1.3–2.8) 222 15.6 (13.7–17.8) 2013–2014 218 8.2 (7.2–9.4) 40 2.9 (2.1–4.0) 178 12.5 (10.8–14.5) - TABLE 4
Baseline characteristics of the 514 patients with primary spontaneous pneumothorax
Variable Overall Female Male Patients 514 75 (15%) 439 (85%) Age on first admission years Median (range) 25 (12–40) 29 (15–40) 24 (12–40) Mean±sd 25.7±7.1 29.2±7.2 25.1±6.9¶ Lung affected initially Right lung 256 (53%) 36 (48%) 220 (50%) Left lung 254 (46%) 37 (49%) 217 (49%) Bilateral 4 (1%) 2 (3%) 2 (1%) Body mass index kg·m−2 Median (range) 20.4 (12.7–33.2) 20.4 (12.7–33.2) 20.4 (13.9–29.2) Mean±sd# 20.7±3.1 20.9±4.5 20.7±2.7 Smoking habits Never-smokers 136 (27%) 22 (29%) 114 (26%) Daily smokers 299 (58%) 36 (48%) 263 (60%) Weekly smokers 12 (2%) 2 (3%) 10 (2%) Less than weekly 8 (1.5%) 3 (4%) 5 (1%) Ex-smokers 21 (4%) 8 (10%) 13 (3%) Unknown 36 (7%) 4 (5%) 32 (7%) #: n=225. ¶: p<0.0001.
- TABLE 5
Characteristics of the hospitalisations with primary spontaneous pneumothorax on first admission
Variable Overall Female Male Patients 514 75 (15%) 439 (85%) Characteristics at first onset Sudden onset of symptoms 490 (95%) 68 (91%) 422 (96%) Admitted to hospital within 24 h after onset 385 (75%) 46 (61%) 339 (77%) Symptom onset during Sleep 82 (16%) 11 (14%) 71 (16%) Rest 359 (70%) 59 (79%) 300 (68%) Normal activities of daily living 56 (11%) 5 (7%) 51 (12%) Exercise 17 (3%) 0 17 (4%) Treatment facility at first admittance Cardiothoracic centre 99 (19%) 14 (19%) 85 (19%) General surgical/medical ward 326 (64%) 45 (60%) 281 (64%) Referred from general ward to cardiothoracic centre 89 (17%) 16 (21%) 73 (17%) Hospitalisation duration days Median (range) 4 (1–30) 4 (1–20) 4 (1–30) Mean±sd 5.1±4.27 5.8±5.03 5.0±4.11 Treatment on first admission Initial treatment Observation 74 (14%) 11 (15%) 63 (14%) Chest tube with/without suction 440 (86%) 64 (85%) 376 (86%) Surgical treatment performed during the first admission VATS resection of blebs with partial pleurectomy or pleural abrasion 88 (17%) 21 (28%) 69 (16%) Resection of bullae by thoracotomy 2 (0.5%) 0 2 (0.5%) VATS: video-assisted thoracoscopic surgery.
Vol 5 Issue 2
Table of Contents
Incidence of primary spontaneous pneumothorax: a validated, register-based nationwide study
