SONOSIM SUMMARY: In this editorial, Savitsky et al. overviews the current state of knowledge surrounding spontaneous pneumothorax (SP) incidence and recurrence rates, diagnostic practices, and management techniques, including the role of ultrasound in pneumothorax identification. The article summarizes findings from recent studies aimed at calculating primary SP incidence rates and discusses their significant limitations, which may have led to misestimated findings and should temper over-generalization of estimated incidence rates to the general population.
Savitsky et al. also summarizes current diagnostic approaches and discusses the need to quantify their value via additional studies. This leads to a commentary on current management recommendations from leading thoracic medical societies and a caution regarding their lack unanimity and largely expert-opinion-based (as opposed to research-proven) advice. The article ends by identifying gaps in knowledge regarding best therapeutic practices (e.g., thoracostomy vs. observational management) and calls for additional research to contribute to the creation of evidence-backed management guidelines.
Savitsky E, Oh SS, Lee JM. The evolving epidemiology and management of spontaneous pneumothorax. JAMA. 2018;320(14):1441-1443.