Causes of Pneumothorax in Patients of Advanced Age and Analysis of Mortality Rates

Aim: Spontaneous pneumothorax (SP) primarily occurs in young males but typically presents as a secondary condition in older adults. Secondary spontaneous pneumothorax (SSP) is life-threatening and demands urgent treatment due to underlying chronic lung diseases. This study evaluates the etiological factors, clinical characteristics, treatment methods, and mortality of SSP in patients aged 60 and older, based on current literature. Methods: This study was conducted by retrospectively analyzing the outcomes of patients aged 60 and older who were followed up for SSP between October 2022 and July 2024. Results: The study included 60 patients who were followed up with SSP and met all inclusion and exclusion criteria. The mean age of the patients was 72.03±8.5 years (range: 60–91). Comorbidities were present in 54 patients (90%), and pulmonary diseases were identified in 31 ca-ses (51.66%). Conservative treatment was applied in six patients (10%), while 55 patients (91%) underwent tube thoracostomy. Pleurodesis was performed in 12 patients (20%), resulting in a signi-ficant reduction in pneumothorax recurrence (p=0.001). Imaging revealed a significant association between bullous structures and the frequency of pneumothorax attacks (p=0.008). Pneumonia was diagnosed in 35% of cases, and mortality occurred in 13 patients, showing statistical significance (p<0.001). Conclusion: SSP is a life-threatening condition requiring timely intervention, particularly challenging in elderly patients. Data indicate that underlying lung disease and bullous structures on imaging increase the risk of pneumothorax recurrence. Prognostic factors associated with mortality include intensive care needs, complications, and pneumonia, highlighting their significance in management outcomes.