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Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease.

Publication ,  Journal Article
Hobbs, BD; Foreman, MG; Bowler, R; Jacobson, F; Make, BJ; Castaldi, PJ; San José Estépar, R; Silverman, EK; Hersh, CP; COPDGene Investigators,
Published in: Ann Am Thorac Soc
November 2014

RATIONALE: The demographic, physiological, and computed tomography (CT) features associated with pneumothorax in smokers with and without chronic obstructive pulmonary disease (COPD) are not clearly defined. OBJECTIVES: We evaluated the hypothesis that pneumothorax in smokers is associated with male sex, tall and thin stature, airflow obstruction, and increased total and subpleural emphysema. METHODS: The study included smokers with and without COPD from the COPDGene Study, with quantitative chest CT analysis. Pleural-based emphysema was assessed on the basis of local histogram measures of emphysema. Pneumothorax history was defined by subject self-report. MEASUREMENTS AND MAIN RESULTS: Pneumothorax was reported in 286 (3.2%) of 9,062 participants. In all participants, risk of prior pneumothorax was significantly higher in men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.08-2.22) and non-Hispanic white subjects (OR, 1.90; 95% CI, 1.34-2.69). Risk of prior pneumothorax was associated with increased percent CT emphysema in all participants and participants with COPD (OR, 1.04 for each 1% increase in emphysema; 95% CI, 1.03-1.06). Increased pleural-based emphysema was independently associated with risk of past pneumothorax in all participants (OR, 1.05 for each 1% increase; 95% CI, 1.01-1.10). In smokers with normal spirometry, risk of past pneumothorax was associated with non-Hispanic white race and lifetime smoking intensity (OR, 1.20 for every 10 pack-years; 95% CI, 1.09-1.33). CONCLUSIONS: Among smokers, pneumothorax is associated with male sex, non-Hispanic white race, and increased percentage of total and subpleural CT emphysema. Pneumothorax was not independently associated with height or lung function, even in participants with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

November 2014

Volume

11

Issue

9

Start / End Page

1387 / 1394

Location

United States

Related Subject Headings

  • White People
  • United States
  • Tomography, X-Ray Computed
  • Smoking
  • Sex Factors
  • Risk Factors
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Pneumothorax
  • Middle Aged
 

Citation

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Hobbs, B. D., Foreman, M. G., Bowler, R., Jacobson, F., Make, B. J., Castaldi, P. J., … COPDGene Investigators, . (2014). Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. Ann Am Thorac Soc, 11(9), 1387–1394. https://doi.org/10.1513/AnnalsATS.201405-224OC
Hobbs, Brian D., Marilyn G. Foreman, Russell Bowler, Francine Jacobson, Barry J. Make, Peter J. Castaldi, Raúl San José Estépar, Edwin K. Silverman, Craig P. Hersh, and Craig P. COPDGene Investigators. “Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease.Ann Am Thorac Soc 11, no. 9 (November 2014): 1387–94. https://doi.org/10.1513/AnnalsATS.201405-224OC.
Hobbs BD, Foreman MG, Bowler R, Jacobson F, Make BJ, Castaldi PJ, et al. Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014 Nov;11(9):1387–94.
Hobbs, Brian D., et al. “Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease.Ann Am Thorac Soc, vol. 11, no. 9, Nov. 2014, pp. 1387–94. Pubmed, doi:10.1513/AnnalsATS.201405-224OC.
Hobbs BD, Foreman MG, Bowler R, Jacobson F, Make BJ, Castaldi PJ, San José Estépar R, Silverman EK, Hersh CP, COPDGene Investigators. Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014 Nov;11(9):1387–1394.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

November 2014

Volume

11

Issue

9

Start / End Page

1387 / 1394

Location

United States

Related Subject Headings

  • White People
  • United States
  • Tomography, X-Ray Computed
  • Smoking
  • Sex Factors
  • Risk Factors
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Pneumothorax
  • Middle Aged