Nadia Fettal1 and Abdessamed Taleb1
1Pulmonary, University Hospital, Sidi bel Abbes, Algeria
Spontaneous pneumothorax is defined by the presence of air in the pleural cavity without history of trauma. This is a significant clinical problem. COPD is a common cause of pneumothorax. The risk of recurrence of spontaneous pneumothorax secondary to COPD is high and various studies quote rates 20-60%.
Methods: retrospective cohort study of all patients COPD admitted with pneumothorax to the pulmonary department between January 2004 and September 2011.
The aim: to assess the frequency of pneumothorax in the COPD and describe its clinical profile and scalable.
Results: in a study period of 6 years, 248 cases with a diagnosis of pneumothorax were reviewed, the rate of pneumothorax secondary to COPD was 67 % (80 patients COPD developed 167 pneumothorax).Our series is composed mainly of men, mean age 59± 8 years. The notion of smoking was found in 100%; ex-smokers 67% and active smokers 33%.The most frequent initial symptom was dyspnea 100% with pleuritic chest pain 42%.The episode of pneumothorax revelated the disease COPD in 32% and was responsible of exacerbation of COPD in 68%.According to GOLD classification, Fifty five (68%) had moderate COPD and twenty five (31%) had severe COPD. All patients received tube chest drainage and hospital stay mean was 12 days range (6-23 days).Twenty eight (35%) had recurrence of pneumothorax. Forty two patients (52%) had emphysema. Four patients developed empyema, six had emphysema subcutaneous and two had pneumonia after chest tube.The evolution was favorable in 74 cases and 6 patients died in an array of acute respiratory failure
Conclusion: pneumothorax represents a factor of mortality for patients suffering of COPD and the surgical treatment is needed to prevent recurrence.