Is Spontaneous Pneumothorax Really a Pediatric Problem? A National Perspective

Objectives: Research on spontaneous pneumothorax (SP) has focused on management strategies in adolescents and adults, yet pediatric population-based data are lacking. The objective of this study was to determine the incidence of SP in the pediatric population in different age groups. Methods: This was a retrospective analysis of patients aged 0 to 17 years hospitalized with a diagnosis of SP from the Healthcare Cost and Utilization Project Kids' Inpatient Database between 1997 and 2006. Trends of overall incidence and demographic information, including age, sex, length of stay, associated procedures, and associated conditions, were obtained and analyzed. Results: The overall incidence of SP in children younger than 18 years increased from 2.68 per 100,000 population in 1997 to 3.41 per 100,000 in 2006. Average age (15.1 years; SE, 0.1 years), age distribution (83% = 15-17 years old), and hospital length of stay (4.7 days; SE, 0.1 days) remained constant. Between 1997 and 2006, males rose from 3.7 times to 4.2 times as likely to develop SP as females. In 2006, 70% of all hospitalized SP patients had therapeutic procedures documented: chest tube (32%), bleb excision (20%), and thoracotomy (8%) were the most common. Emphysematous bleb (21%), asthma (10%), and tobacco use (4%) were the most common associated diagnoses in 2006. Conclusions: Although uncommon in children, SP appears to be primarily a condition of males and adolescents and appears to be increasing in incidence in this population. According to these data, a large portion of children are being managed without procedural intervention.