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Spontaneous pneumothorax

Oxford researchers supported by the NIHR Oxford Biomedical Research Centre have published research that shows how the rates of incidence and recurrence of spontaneous pneumothorax have changed over time.

The research, published on 9 October in the Journal of the American Medical Association, involved teams from the Oxford BRC’s Respiratory and Clinical Informatics themes, using almost 50 years of data held by the Unit of Healthcare Epidemiology in the University of Oxford’s Big Data Institute.

Spontaneous pneumothorax is a common disease known to have an unusual epidemiological profile, but there are limited contemporary population-based data.

Looking at English national data from 1968 to 2016, the researchers found that the annual hospital admission rate for spontaneous pneumothorax in England increased from 9.1 to 14.1 per 100,000 population, with differences by sex and by age.

Between these dates, there were 170,929 hospital admissions for spontaneous pneumothorax, with the majority (73 per cent) being men.

Of patients with spontaneous pneumothorax, 60.8% had chronic lung disease.

Record-linkage analysis showed that the overall increase in admissions over time could be due in part to an increase in repeat admissions, but there were also significant increases in the annual rate of first-known spontaneous pneumothorax admissions in some population subgroups, for example women aged 65 and older.

The study found that the probability of recurrence within five years was similar by sex, but there were variations according to age group and the presence of chronic lung disease.

Raphael Goldacre, one of the study's authors, said 'The size of the dataset used was a real strength of the study. Over 265 million hospitalisation records in England were searched, which meant that we were able split the population into various subgroups to quantify who is most at risk of pneumothorax and its recurrence. The record-linked data from the Oxford Record Linkage Study, which goes back to the 1960s, also allowed us comprehensively to trace annual admission rates for this condition across five decades.

'The messages we want to deliver are, firstly, that pneumothorax has become more common among the elderly, particularly among elderly women.  Secondly, we hope that respiratory clinicians and GPs will be able to use our findings on recurrence to inform patients about their chances of having a second pneumothorax based on the patient's characteristics.'

Read more about the findings.