Catamenial pneumothorax: A population-based study

Study objective: To characterize the incidence, clinical features, and demographic characteristics of women with catamenial pneumothorax with the use of a large national database in the United States. Design: Retrospective case control study of the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) database between 2004 and 2014. Setting: Not applicable. Patients: Women, aged 18–50 years, who were diagnosed with a pneumothorax between 2004 and 2014. Intervention: Not applicable. Measurements: The cohort was constructed using the appropriate ICD-9 codes utilizing HCUP-NIS, checking for women with spontaneous and catamenial pneumothorax . Main results: Of a total 6234 women with spontaneous pneumothorax, 80 women (1.3%) had a diagnosis of catamenial pneumothorax. Women with catamenial pneumothorax were more likely to be black, have private insurance and be treated in an urban hospital. In addition, fewer patients in this group reported a history of tobacco consumption. Patients in the study group were more likely to have concomitant pelvic endometriosis, dysmenorrhea, and infertility. Compared to women with non-catamenial pneumothorax, those with catamenial pneumothorax were more frequently treated with thoracic drainage and underwent pleural and diaphragm biopsies. Conclusion: Catamenial pneumothorax is a rare entity with a distinct clinical profile. This condition is associated with pelvic endometriosis, has a predilection for surgical intervention and is associated with lower rates of smoking.