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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2206v1 131/6/1877    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Alifano, M. Articles by Roche, N. Search for Related Content PubMed PubMed Citation Articles by Alifano, M. Articles by Roche, N.

Atmospheric pressure influences the risk of pneumothorax: beware of the storm!

¹Thoracic Surgery Unit, Hôtel-Dieu University Hospital, Paris, France ²Thoracic Surgery Unit, Maggiore-Bellaria Hospital, Bologna, Italy ³Health Information Unit, Bologna Hospitals, and ⁴Pneumology Unit, Hôtel-Dieu Hospital, Paris V University, Paris, France

marco.alifano{at}htd.aphp.fr

Abstract

BackgroundIdiopathic spontaneous pneumothorax (ISP) results from rupture of blebs, bullas, or diseased alveolar walls. Initiating mechanisms may relate to increased transpulmonary pressure. The possible impact of changes in atmospheric pressure on the occurrence of ISP remains uncertain.

MethodsWe studied the relationship between occurrence of ISP and meteorological conditions during a 4-year period in the urban area of Bologna, Italy, in which all cases of pneumothorax can be exhaustively identified. For each day of the study period, atmospheric pressure (P_atm) and ambient temperature were obtained from the local meteorological institute. A cluster was defined as the admission of at least two patients with pneumothorax within 3 days of each other.

ResultsThere were 294 episodes of ISP; 247 (84%) occurred in 76 clusters. Clusters were significantly associated with wider differences in P_atm between index day (first day of the cluster) and previous day (difference in mean P_atm: -1.23± 0.45 mmHg -mean± SEM- versus +0.04± 0.12, respectively; analysis of variance: p=0.01). Similarly, pneumothorax and storms (but not temperature) were significantly associated (Chi-square test: p<0.0001).

ConclusionsThis large-scale study shows that patients with ISP are hospitalized in clusters and suggests that important variations in atmospheric pressure may be involved. The knowledge of this relationship may help understanding the pathophysiology of the disease.

Key Words: pneumothorax • temperature • pressure • storms