Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

OBJECTIVES: This study was conducted to explore the association between pneumoconiosis and pneumothorax. DESIGN: Retrospective cohort study. SETTING: Nationwide population-based study using the Taiwan National Health Insurance Database. PARTICIPANTS: A total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort). PRIMARY AND SECONDARY OUTCOME MEASURES: The incidence and the cumulative incidence of pneumothorax. RESULTS: Both incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients. CONCLUSIONS: Our study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.