Surgical management patterns for spontaneous pneumothorax in adolescents and young adults.

Document Type

Article

Publication Date

11-2025

Identifier

DOI: 10.1016/j.surg.2025.109644

Abstract

BACKGROUND: Management of primary spontaneous pneumothorax varies widely. We aimed to assess national trends in PSP management in the last decade.

METHODS: We conducted a 10-year retrospective analysis of the MarketScan claims database to identify adolescents and young adults (aged 10-24 years) diagnosed with primary spontaneous pneumothorax (2012-2021). Outcomes during index admission and recurrence included imaging, drainage procedures (aspiration or tube thoracostomy), surgery, and length of stay. Thirty-day postoperative outcomes included emergency department visits, readmission, and return to the operating room.

RESULTS: Among 2,480 patients (mean age 18.9 years; 83.7% male), 41.5% underwent a computed tomography scan of the chest. During index admission, 60.9% underwent a drainage procedure. Surgeries were performed in 32.3% (n = 801) of patients after a mean of 4.1 (standard deviation, 2.7) days. Over the 10-year period, the use of cross-sectional imaging utilization increased (odds ratio, 1.04; 95% confidence interval, 1.01-1.07, P = .008) but time to surgical intervention remained unchanged. Median length of stay was 4 days (interquartile range, 2-6). Those who underwent surgery were less likely to experience readmission (4.9% vs 19.8%, P < .001) or have an visit to the emergency department (12.6% vs. 21.7%, P < .001) within 30 days compared with those with no surgery. At 1 year, approximately 9.5% of patients experienced a recurrence that resulted in an admission, with nearly 75% undergoing surgery.

CONCLUSION: Management of primary spontaneous pneumothorax in adolescents and young adults varies based on clinical presentation and patient factors. Reducing the use of computed tomography and expediting decision-making process for proceeding to the operating room may serve as potential targets for optimizing health care resource use.

Journal Title

Surgery

Volume

187

First Page

109644

Last Page

109644

MeSH Keywords

Humans; Pneumothorax; Adolescent; Male; Female; Retrospective Studies; Young Adult; Child; Drainage; Length of Stay; Tomography, X-Ray Computed; Recurrence; Patient Readmission; Thoracostomy; Treatment Outcome; Chest Tubes

PubMed ID

40907218

Keywords

Pneumothorax; Retrospective Studies; Drainage; Length of Stay; Tomography, X-Ray Computed; Recurrence; Patient Readmission; Thoracostomy; Treatment Outcome; Chest Tubes

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