Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease

Brian D. Hobbs, Marilyn G. Foreman, Russell Bowler, Francine Jacobson, Barry J. Make, Peter J. Castaldi, Raú L San José Estépar, Edwin K. Silverman, Craig P. Hersh, Jeffrey Curtis, Ella Kazerooni, Nicola Hanania, Philip Alapat, Venkata Bandi, Kalpalatha Guntupalli, Elizabeth Guy, Antara Mallampalli, Charles Trinh, Mustafa Atik, Hasan Al-Azzawi & 97 others Marc Willis, Susan Pinero, Linda Fahr, Arun Nachiappan, Collin Bray, L. Alexander Frigini, Carlos Farinas, David Katz, Jose Freytes, Anne Marie Marciel, Dawn Demeo, Craig Hersh, George Washko, Hiroto Hatabu, Peter Clarke, Ritu Gill, Andetta Hunsaker, Beatrice Trotman-Dickenson, Rachna Madan, R. Graham Barr, Byron Thomashow, John Austin, Belinda D'Souza, Neil MacIntyre, Lacey Washington, H. Page McAdams, Richard Rosiello, Timothy Bresnahan, Joseph Bradley, Sharon Kuong, Steven Meller, Suzanne Roland, Charlene Mcevoy, Joseph Tashjian, Robert A Wise, Nadia Hansel, Robert Howard Brown, Gregory B Diette, Karen M Horton, Richard Casaburi, Janos Porszasz, Hans Fischer, Matt Budoff, Michael E. Debakey, Amir Sharafkhaneh, Hirani Kamal, Roham Darvishi, Dennis Niewoehner, Quentin Anderson, Kathryn Rice, Audrey Caine, Marilyn Foreman, Gloria Westney, Eugene Berkowitz, David Lynch, Joyce Schroeder, Valerie Hale, John Armstrong, Debra Dyer, Jonathan Chung, Christian Cox, Gerard Criner, Victor Kim, Nathaniel Marchetti, Aditi Satti, A. James Mamary, Robert Steiner, Chandra Dass, Libby Cone, William Bailey, Mark Dransfield, Michael Wells, Surya Bhatt, Hrudaya Nath, Satinder Singh, Joe Ramsdell, Paul Friedman, Alejandro Cornellas, John Newell, Edwin J R Van Beek, Fernando Martinez, MeiLan Han, Christine Wendt, Tadashi Allen, Frank Sciurba, Joel Weissfeld, Carl Fuhrman, Jessica Bon, Danielle Hooper, Antonio Anzueto, Sandra Adams, Carlos Orozco, Mario Ruiz, Amy Mumbower, Ariel Kruger, Carlos Restrepo, Michael Lane

Research output: Contribution to journalArticle

Abstract

Rationale: The demographic, physiological, and computed tomography (CT) features associated with pneumothorax in smokers with and without chronic obstructive pulmonary disease (COPD) are not clearly defined.

Objectives: We evaluated the hypothesis that pneumothorax in smokers is associated with male sex, tall and thin stature, airflow obstruction, and increased total and subpleural emphysema.

Methods: The study included smokers with and without COPD from the COPDGene Study, with quantitative chest CT analysis. Pleural-based emphysema was assessed on the basis of local histogram measures of emphysema. Pneumothorax history was defined by subject self-report.

Measurements and Main Results: Pneumothorax was reported in 286 (3.2%) of 9,062 participants. In all participants, risk of prior pneumothorax was significantly higher in men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.08-2.22) and non-Hispanic white subjects (OR, 1.90; 95% CI, 1.34-2.69). Risk of prior pneumothorax was associated with increased percent CT emphysema in all participants and participants with COPD (OR, 1.04 for each 1% increase in emphysema; 95% CI, 1.03-1.06). Increased pleural-based emphysema was independently associated with risk of past pneumothorax in all participants (OR, 1.05 for each 1% increase; 95% CI, 1.01-1.10). In smokers with normal spirometry, risk of past pneumothorax was associated with non-Hispanic white race and lifetime smoking intensity (OR, 1.20 for every 10 pack-years; 95% CI, 1.09-1.33).

Conclusions: Among smokers, pneumothorax is associated with male sex, non-Hispanic white race, and increased percentage of total and subpleural CT emphysema. Pneumothorax was not independently associated with height or lung function, even in participants with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

Original languageEnglish (US)
Pages (from-to)1387-1394
Number of pages8
JournalAnnals of the American Thoracic Society
Volume11
Issue number9
DOIs
StatePublished - Nov 1 2014

Fingerprint

Pneumothorax
Chronic Obstructive Pulmonary Disease
Emphysema
Odds Ratio
Confidence Intervals
Tomography
Spirometry
Self Report
Thorax
Smoking
Demography
Clinical Trials
Lung

Keywords

  • Chronic obstructive pulmonary disease
  • Emphysema
  • Pneumothorax

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Hobbs, B. D., Foreman, M. G., Bowler, R., Jacobson, F., Make, B. J., Castaldi, P. J., ... Lane, M. (2014). Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. Annals of the American Thoracic Society, 11(9), 1387-1394. https://doi.org/10.1513/AnnalsATS.201405-224OC

Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. / Hobbs, Brian D.; Foreman, Marilyn G.; Bowler, Russell; Jacobson, Francine; Make, Barry J.; Castaldi, Peter J.; Estépar, Raú L San José; Silverman, Edwin K.; Hersh, Craig P.; Curtis, Jeffrey; Kazerooni, Ella; Hanania, Nicola; Alapat, Philip; Bandi, Venkata; Guntupalli, Kalpalatha; Guy, Elizabeth; Mallampalli, Antara; Trinh, Charles; Atik, Mustafa; Al-Azzawi, Hasan; Willis, Marc; Pinero, Susan; Fahr, Linda; Nachiappan, Arun; Bray, Collin; Frigini, L. Alexander; Farinas, Carlos; Katz, David; Freytes, Jose; Marciel, Anne Marie; Demeo, Dawn; Hersh, Craig; Washko, George; Hatabu, Hiroto; Clarke, Peter; Gill, Ritu; Hunsaker, Andetta; Trotman-Dickenson, Beatrice; Madan, Rachna; Barr, R. Graham; Thomashow, Byron; Austin, John; D'Souza, Belinda; MacIntyre, Neil; Washington, Lacey; McAdams, H. Page; Rosiello, Richard; Bresnahan, Timothy; Bradley, Joseph; Kuong, Sharon; Meller, Steven; Roland, Suzanne; Mcevoy, Charlene; Tashjian, Joseph; Wise, Robert A; Hansel, Nadia; Brown, Robert Howard; Diette, Gregory B; Horton, Karen M; Casaburi, Richard; Porszasz, Janos; Fischer, Hans; Budoff, Matt; Debakey, Michael E.; Sharafkhaneh, Amir; Kamal, Hirani; Darvishi, Roham; Niewoehner, Dennis; Anderson, Quentin; Rice, Kathryn; Caine, Audrey; Foreman, Marilyn; Westney, Gloria; Berkowitz, Eugene; Lynch, David; Schroeder, Joyce; Hale, Valerie; Armstrong, John; Dyer, Debra; Chung, Jonathan; Cox, Christian; Criner, Gerard; Kim, Victor; Marchetti, Nathaniel; Satti, Aditi; Mamary, A. James; Steiner, Robert; Dass, Chandra; Cone, Libby; Bailey, William; Dransfield, Mark; Wells, Michael; Bhatt, Surya; Nath, Hrudaya; Singh, Satinder; Ramsdell, Joe; Friedman, Paul; Cornellas, Alejandro; Newell, John; Van Beek, Edwin J R; Martinez, Fernando; Han, MeiLan; Wendt, Christine; Allen, Tadashi; Sciurba, Frank; Weissfeld, Joel; Fuhrman, Carl; Bon, Jessica; Hooper, Danielle; Anzueto, Antonio; Adams, Sandra; Orozco, Carlos; Ruiz, Mario; Mumbower, Amy; Kruger, Ariel; Restrepo, Carlos; Lane, Michael.

In: Annals of the American Thoracic Society, Vol. 11, No. 9, 01.11.2014, p. 1387-1394.

Research output: Contribution to journalArticle

Hobbs, BD, Foreman, MG, Bowler, R, Jacobson, F, Make, BJ, Castaldi, PJ, Estépar, RLSJ, Silverman, EK, Hersh, CP, Curtis, J, Kazerooni, E, Hanania, N, Alapat, P, Bandi, V, Guntupalli, K, Guy, E, Mallampalli, A, Trinh, C, Atik, M, Al-Azzawi, H, Willis, M, Pinero, S, Fahr, L, Nachiappan, A, Bray, C, Frigini, LA, Farinas, C, Katz, D, Freytes, J, Marciel, AM, Demeo, D, Hersh, C, Washko, G, Hatabu, H, Clarke, P, Gill, R, Hunsaker, A, Trotman-Dickenson, B, Madan, R, Barr, RG, Thomashow, B, Austin, J, D'Souza, B, MacIntyre, N, Washington, L, McAdams, HP, Rosiello, R, Bresnahan, T, Bradley, J, Kuong, S, Meller, S, Roland, S, Mcevoy, C, Tashjian, J, Wise, RA, Hansel, N, Brown, RH, Diette, GB, Horton, KM, Casaburi, R, Porszasz, J, Fischer, H, Budoff, M, Debakey, ME, Sharafkhaneh, A, Kamal, H, Darvishi, R, Niewoehner, D, Anderson, Q, Rice, K, Caine, A, Foreman, M, Westney, G, Berkowitz, E, Lynch, D, Schroeder, J, Hale, V, Armstrong, J, Dyer, D, Chung, J, Cox, C, Criner, G, Kim, V, Marchetti, N, Satti, A, Mamary, AJ, Steiner, R, Dass, C, Cone, L, Bailey, W, Dransfield, M, Wells, M, Bhatt, S, Nath, H, Singh, S, Ramsdell, J, Friedman, P, Cornellas, A, Newell, J, Van Beek, EJR, Martinez, F, Han, M, Wendt, C, Allen, T, Sciurba, F, Weissfeld, J, Fuhrman, C, Bon, J, Hooper, D, Anzueto, A, Adams, S, Orozco, C, Ruiz, M, Mumbower, A, Kruger, A, Restrepo, C & Lane, M 2014, 'Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease', Annals of the American Thoracic Society, vol. 11, no. 9, pp. 1387-1394. https://doi.org/10.1513/AnnalsATS.201405-224OC
Hobbs, Brian D. ; Foreman, Marilyn G. ; Bowler, Russell ; Jacobson, Francine ; Make, Barry J. ; Castaldi, Peter J. ; Estépar, Raú L San José ; Silverman, Edwin K. ; Hersh, Craig P. ; Curtis, Jeffrey ; Kazerooni, Ella ; Hanania, Nicola ; Alapat, Philip ; Bandi, Venkata ; Guntupalli, Kalpalatha ; Guy, Elizabeth ; Mallampalli, Antara ; Trinh, Charles ; Atik, Mustafa ; Al-Azzawi, Hasan ; Willis, Marc ; Pinero, Susan ; Fahr, Linda ; Nachiappan, Arun ; Bray, Collin ; Frigini, L. Alexander ; Farinas, Carlos ; Katz, David ; Freytes, Jose ; Marciel, Anne Marie ; Demeo, Dawn ; Hersh, Craig ; Washko, George ; Hatabu, Hiroto ; Clarke, Peter ; Gill, Ritu ; Hunsaker, Andetta ; Trotman-Dickenson, Beatrice ; Madan, Rachna ; Barr, R. Graham ; Thomashow, Byron ; Austin, John ; D'Souza, Belinda ; MacIntyre, Neil ; Washington, Lacey ; McAdams, H. Page ; Rosiello, Richard ; Bresnahan, Timothy ; Bradley, Joseph ; Kuong, Sharon ; Meller, Steven ; Roland, Suzanne ; Mcevoy, Charlene ; Tashjian, Joseph ; Wise, Robert A ; Hansel, Nadia ; Brown, Robert Howard ; Diette, Gregory B ; Horton, Karen M ; Casaburi, Richard ; Porszasz, Janos ; Fischer, Hans ; Budoff, Matt ; Debakey, Michael E. ; Sharafkhaneh, Amir ; Kamal, Hirani ; Darvishi, Roham ; Niewoehner, Dennis ; Anderson, Quentin ; Rice, Kathryn ; Caine, Audrey ; Foreman, Marilyn ; Westney, Gloria ; Berkowitz, Eugene ; Lynch, David ; Schroeder, Joyce ; Hale, Valerie ; Armstrong, John ; Dyer, Debra ; Chung, Jonathan ; Cox, Christian ; Criner, Gerard ; Kim, Victor ; Marchetti, Nathaniel ; Satti, Aditi ; Mamary, A. James ; Steiner, Robert ; Dass, Chandra ; Cone, Libby ; Bailey, William ; Dransfield, Mark ; Wells, Michael ; Bhatt, Surya ; Nath, Hrudaya ; Singh, Satinder ; Ramsdell, Joe ; Friedman, Paul ; Cornellas, Alejandro ; Newell, John ; Van Beek, Edwin J R ; Martinez, Fernando ; Han, MeiLan ; Wendt, Christine ; Allen, Tadashi ; Sciurba, Frank ; Weissfeld, Joel ; Fuhrman, Carl ; Bon, Jessica ; Hooper, Danielle ; Anzueto, Antonio ; Adams, Sandra ; Orozco, Carlos ; Ruiz, Mario ; Mumbower, Amy ; Kruger, Ariel ; Restrepo, Carlos ; Lane, Michael. / Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. In: Annals of the American Thoracic Society. 2014 ; Vol. 11, No. 9. pp. 1387-1394.
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abstract = "Rationale: The demographic, physiological, and computed tomography (CT) features associated with pneumothorax in smokers with and without chronic obstructive pulmonary disease (COPD) are not clearly defined.Objectives: We evaluated the hypothesis that pneumothorax in smokers is associated with male sex, tall and thin stature, airflow obstruction, and increased total and subpleural emphysema.Methods: The study included smokers with and without COPD from the COPDGene Study, with quantitative chest CT analysis. Pleural-based emphysema was assessed on the basis of local histogram measures of emphysema. Pneumothorax history was defined by subject self-report.Measurements and Main Results: Pneumothorax was reported in 286 (3.2{\%}) of 9,062 participants. In all participants, risk of prior pneumothorax was significantly higher in men (odds ratio [OR], 1.55; 95{\%} confidence interval [CI], 1.08-2.22) and non-Hispanic white subjects (OR, 1.90; 95{\%} CI, 1.34-2.69). Risk of prior pneumothorax was associated with increased percent CT emphysema in all participants and participants with COPD (OR, 1.04 for each 1{\%} increase in emphysema; 95{\%} CI, 1.03-1.06). Increased pleural-based emphysema was independently associated with risk of past pneumothorax in all participants (OR, 1.05 for each 1{\%} increase; 95{\%} CI, 1.01-1.10). In smokers with normal spirometry, risk of past pneumothorax was associated with non-Hispanic white race and lifetime smoking intensity (OR, 1.20 for every 10 pack-years; 95{\%} CI, 1.09-1.33).Conclusions: Among smokers, pneumothorax is associated with male sex, non-Hispanic white race, and increased percentage of total and subpleural CT emphysema. Pneumothorax was not independently associated with height or lung function, even in participants with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).",
keywords = "Chronic obstructive pulmonary disease, Emphysema, Pneumothorax",
author = "Hobbs, {Brian D.} and Foreman, {Marilyn G.} and Russell Bowler and Francine Jacobson and Make, {Barry J.} and Castaldi, {Peter J.} and Est{\'e}par, {Ra{\'u} L San Jos{\'e}} and Silverman, {Edwin K.} and Hersh, {Craig P.} and Jeffrey Curtis and Ella Kazerooni and Nicola Hanania and Philip Alapat and Venkata Bandi and Kalpalatha Guntupalli and Elizabeth Guy and Antara Mallampalli and Charles Trinh and Mustafa Atik and Hasan Al-Azzawi and Marc Willis and Susan Pinero and Linda Fahr and Arun Nachiappan and Collin Bray and Frigini, {L. Alexander} and Carlos Farinas and David Katz and Jose Freytes and Marciel, {Anne Marie} and Dawn Demeo and Craig Hersh and George Washko and Hiroto Hatabu and Peter Clarke and Ritu Gill and Andetta Hunsaker and Beatrice Trotman-Dickenson and Rachna Madan and Barr, {R. Graham} and Byron Thomashow and John Austin and Belinda D'Souza and Neil MacIntyre and Lacey Washington and McAdams, {H. Page} and Richard Rosiello and Timothy Bresnahan and Joseph Bradley and Sharon Kuong and Steven Meller and Suzanne Roland and Charlene Mcevoy and Joseph Tashjian and Wise, {Robert A} and Nadia Hansel and Brown, {Robert Howard} and Diette, {Gregory B} and Horton, {Karen M} and Richard Casaburi and Janos Porszasz and Hans Fischer and Matt Budoff and Debakey, {Michael E.} and Amir Sharafkhaneh and Hirani Kamal and Roham Darvishi and Dennis Niewoehner and Quentin Anderson and Kathryn Rice and Audrey Caine and Marilyn Foreman and Gloria Westney and Eugene Berkowitz and David Lynch and Joyce Schroeder and Valerie Hale and John Armstrong and Debra Dyer and Jonathan Chung and Christian Cox and Gerard Criner and Victor Kim and Nathaniel Marchetti and Aditi Satti and Mamary, {A. James} and Robert Steiner and Chandra Dass and Libby Cone and William Bailey and Mark Dransfield and Michael Wells and Surya Bhatt and Hrudaya Nath and Satinder Singh and Joe Ramsdell and Paul Friedman and Alejandro Cornellas and John Newell and {Van Beek}, {Edwin J R} and Fernando Martinez and MeiLan Han and Christine Wendt and Tadashi Allen and Frank Sciurba and Joel Weissfeld and Carl Fuhrman and Jessica Bon and Danielle Hooper and Antonio Anzueto and Sandra Adams and Carlos Orozco and Mario Ruiz and Amy Mumbower and Ariel Kruger and Carlos Restrepo and Michael Lane",
year = "2014",
month = "11",
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doi = "10.1513/AnnalsATS.201405-224OC",
language = "English (US)",
volume = "11",
pages = "1387--1394",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
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TY - JOUR

T1 - Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease

AU - Hobbs, Brian D.

AU - Foreman, Marilyn G.

AU - Bowler, Russell

AU - Jacobson, Francine

AU - Make, Barry J.

AU - Castaldi, Peter J.

AU - Estépar, Raú L San José

AU - Silverman, Edwin K.

AU - Hersh, Craig P.

AU - Curtis, Jeffrey

AU - Kazerooni, Ella

AU - Hanania, Nicola

AU - Alapat, Philip

AU - Bandi, Venkata

AU - Guntupalli, Kalpalatha

AU - Guy, Elizabeth

AU - Mallampalli, Antara

AU - Trinh, Charles

AU - Atik, Mustafa

AU - Al-Azzawi, Hasan

AU - Willis, Marc

AU - Pinero, Susan

AU - Fahr, Linda

AU - Nachiappan, Arun

AU - Bray, Collin

AU - Frigini, L. Alexander

AU - Farinas, Carlos

AU - Katz, David

AU - Freytes, Jose

AU - Marciel, Anne Marie

AU - Demeo, Dawn

AU - Hersh, Craig

AU - Washko, George

AU - Hatabu, Hiroto

AU - Clarke, Peter

AU - Gill, Ritu

AU - Hunsaker, Andetta

AU - Trotman-Dickenson, Beatrice

AU - Madan, Rachna

AU - Barr, R. Graham

AU - Thomashow, Byron

AU - Austin, John

AU - D'Souza, Belinda

AU - MacIntyre, Neil

AU - Washington, Lacey

AU - McAdams, H. Page

AU - Rosiello, Richard

AU - Bresnahan, Timothy

AU - Bradley, Joseph

AU - Kuong, Sharon

AU - Meller, Steven

AU - Roland, Suzanne

AU - Mcevoy, Charlene

AU - Tashjian, Joseph

AU - Wise, Robert A

AU - Hansel, Nadia

AU - Brown, Robert Howard

AU - Diette, Gregory B

AU - Horton, Karen M

AU - Casaburi, Richard

AU - Porszasz, Janos

AU - Fischer, Hans

AU - Budoff, Matt

AU - Debakey, Michael E.

AU - Sharafkhaneh, Amir

AU - Kamal, Hirani

AU - Darvishi, Roham

AU - Niewoehner, Dennis

AU - Anderson, Quentin

AU - Rice, Kathryn

AU - Caine, Audrey

AU - Foreman, Marilyn

AU - Westney, Gloria

AU - Berkowitz, Eugene

AU - Lynch, David

AU - Schroeder, Joyce

AU - Hale, Valerie

AU - Armstrong, John

AU - Dyer, Debra

AU - Chung, Jonathan

AU - Cox, Christian

AU - Criner, Gerard

AU - Kim, Victor

AU - Marchetti, Nathaniel

AU - Satti, Aditi

AU - Mamary, A. James

AU - Steiner, Robert

AU - Dass, Chandra

AU - Cone, Libby

AU - Bailey, William

AU - Dransfield, Mark

AU - Wells, Michael

AU - Bhatt, Surya

AU - Nath, Hrudaya

AU - Singh, Satinder

AU - Ramsdell, Joe

AU - Friedman, Paul

AU - Cornellas, Alejandro

AU - Newell, John

AU - Van Beek, Edwin J R

AU - Martinez, Fernando

AU - Han, MeiLan

AU - Wendt, Christine

AU - Allen, Tadashi

AU - Sciurba, Frank

AU - Weissfeld, Joel

AU - Fuhrman, Carl

AU - Bon, Jessica

AU - Hooper, Danielle

AU - Anzueto, Antonio

AU - Adams, Sandra

AU - Orozco, Carlos

AU - Ruiz, Mario

AU - Mumbower, Amy

AU - Kruger, Ariel

AU - Restrepo, Carlos

AU - Lane, Michael

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Rationale: The demographic, physiological, and computed tomography (CT) features associated with pneumothorax in smokers with and without chronic obstructive pulmonary disease (COPD) are not clearly defined.Objectives: We evaluated the hypothesis that pneumothorax in smokers is associated with male sex, tall and thin stature, airflow obstruction, and increased total and subpleural emphysema.Methods: The study included smokers with and without COPD from the COPDGene Study, with quantitative chest CT analysis. Pleural-based emphysema was assessed on the basis of local histogram measures of emphysema. Pneumothorax history was defined by subject self-report.Measurements and Main Results: Pneumothorax was reported in 286 (3.2%) of 9,062 participants. In all participants, risk of prior pneumothorax was significantly higher in men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.08-2.22) and non-Hispanic white subjects (OR, 1.90; 95% CI, 1.34-2.69). Risk of prior pneumothorax was associated with increased percent CT emphysema in all participants and participants with COPD (OR, 1.04 for each 1% increase in emphysema; 95% CI, 1.03-1.06). Increased pleural-based emphysema was independently associated with risk of past pneumothorax in all participants (OR, 1.05 for each 1% increase; 95% CI, 1.01-1.10). In smokers with normal spirometry, risk of past pneumothorax was associated with non-Hispanic white race and lifetime smoking intensity (OR, 1.20 for every 10 pack-years; 95% CI, 1.09-1.33).Conclusions: Among smokers, pneumothorax is associated with male sex, non-Hispanic white race, and increased percentage of total and subpleural CT emphysema. Pneumothorax was not independently associated with height or lung function, even in participants with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

AB - Rationale: The demographic, physiological, and computed tomography (CT) features associated with pneumothorax in smokers with and without chronic obstructive pulmonary disease (COPD) are not clearly defined.Objectives: We evaluated the hypothesis that pneumothorax in smokers is associated with male sex, tall and thin stature, airflow obstruction, and increased total and subpleural emphysema.Methods: The study included smokers with and without COPD from the COPDGene Study, with quantitative chest CT analysis. Pleural-based emphysema was assessed on the basis of local histogram measures of emphysema. Pneumothorax history was defined by subject self-report.Measurements and Main Results: Pneumothorax was reported in 286 (3.2%) of 9,062 participants. In all participants, risk of prior pneumothorax was significantly higher in men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.08-2.22) and non-Hispanic white subjects (OR, 1.90; 95% CI, 1.34-2.69). Risk of prior pneumothorax was associated with increased percent CT emphysema in all participants and participants with COPD (OR, 1.04 for each 1% increase in emphysema; 95% CI, 1.03-1.06). Increased pleural-based emphysema was independently associated with risk of past pneumothorax in all participants (OR, 1.05 for each 1% increase; 95% CI, 1.01-1.10). In smokers with normal spirometry, risk of past pneumothorax was associated with non-Hispanic white race and lifetime smoking intensity (OR, 1.20 for every 10 pack-years; 95% CI, 1.09-1.33).Conclusions: Among smokers, pneumothorax is associated with male sex, non-Hispanic white race, and increased percentage of total and subpleural CT emphysema. Pneumothorax was not independently associated with height or lung function, even in participants with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

KW - Chronic obstructive pulmonary disease

KW - Emphysema

KW - Pneumothorax

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U2 - 10.1513/AnnalsATS.201405-224OC

DO - 10.1513/AnnalsATS.201405-224OC

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JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 9

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