Secondary spontaneous pneumothorax risk elevated in Black adults, men with COPD, emphysema
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The prevalence and incidence of secondary spontaneous pneumothorax among patients with chronic obstructive pulmonary disease and emphysema is increased in Black adults and men, researchers reported at the virtual CHEST Annual Meeting.
“COPD and emphysema are considered the most common causes of secondary spontaneous pneumothorax,” Dayyan M. Adoor, MD, resident physician in the department of internal medicine and the department of pulmonology and critical care at the University Hospitals Cleveland Medical Center, said during his presentation at the virtual CHEST Annual Meeting. “Our goal was to describe the prevalence and incidence of secondary spontaneous pneumothorax among patients with COPD and emphysema in the U.S. and identify its potential risk factors.”
Researchers assessed electronic health data from 27 U.S. health care systems and identified 1,167,490 individuals with COPD or emphysema from April 2015 to April 2020. The researchers then identified patients with first-ever spontaneous pneumothorax and calculated 5-year prevalence and incidence and characterized data stratified for race and sex.
Compared with individuals without COPD or emphysema, spontaneous pneumothorax prevalence was higher among those with COPD or emphysema, at 345 per 100,000 persons compared with 30 per 100,000 persons (prevalence ratio [PR] = 11.41; 95% CI, 11.01-11.83).
Secondary spontaneous pneumothorax prevalence was significantly higher among Black individuals compared with white individuals, at 423 per 100,000 persons compared with 344 per 100,000 persons (PR = 1.23; 95% CI, 1.12-1.36). Prevalence was also higher among men compared with women (PR = 1.95; 95% CI, 1.82-2.08).
Annual incidence of first-ever secondary spontaneous pneumothorax was 50 cases per 100,000 persons per year (0.05%) among those with COPD or emphysema from 2019 to 2020. Annual incidence was higher among Black individuals compared with white individuals (90 cases vs. 46 cases per 100,000 persons per year) and higher among men compared with women (69 cases vs. 31 cases per 100,000 persons per year).
“It is not very well understood as to why certain demographic characteristics increase predisposition to secondary spontaneous pneumothorax in patients with COPD and emphysema,” Adoor said. “Furthermore, whether these high-risk patients are candidates for prophylactic chemic pleurodesis could also be explored in future studies.”