RT Journal Article
SR Electronic
T1 Risk factors associated to surgical treatment of parapneumonic effusion and empyema
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4383
VO 42
IS Suppl 57
A1 Renata Báez-Saldaña
A1 Héctor Molina-Corona
A1 María Elena Martínez-Rendón
A1 Araceli Santillán-Martínez
A1 Araceli Escobar-Rojas
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4383.abstract
AB IntroductionCurrently there is no clear data to define the point at which a patient with parapneumonic effusion and empyema should proceed to surgical intervention and little is known about its associated risk factors.ObjectiveTo identify risk factors associated to surgical treatment in patients with parapneumonic effusion and empyema.Material and MethodsProspective cohort of consecutive patients with parapneumonic effusion and empyema. Variables recorded: clinical characteristics, pleural fluid features, risk categorization for a poor outcome in patients with parapneumonic effusions and empyema, surgical treatment as outcome and its associated risk factors.Results217 patients were included, of these 52 (24%) had parapeumonic effusion and 165 (76%) had empyema. 163 (75.11%) were men, 72 (33.17%) had diabetes. 100 cases (46%) had two or more loculations, 32 of these cases did not proceed to surgical treatment. 116 (53.45%) were risk category 4 and 105 (48.38%) required surgical treatment.Mutivariate analysis revealed an increasing likelihood for surgical treatment with two or more loculations OR 2.94(IC 95% 1.54-5.63 p=0.001), more than 12000 leukocytes RM 2.30(IC 95% 1.23-4.31 p=0.009), diabetes RM 2.23(IC 95% 1.12–4.46 p=0.023), risk categorization for a poor outcome in empyema RM 9.59(IC 95% 1.12–8.23 p=0.000) and age RM 0.98(IC 95% 0.96–0.99 p=0.046).ConclusionsSurgical treatment decision is based on local protocols, institutional experience and individual case management with a flexible sequence of procedures.However, two or more loculations, risk categorization for a poor outcome in parapneumonic effusion and empyema, diabetes and leukocytosis are good predictors for surgical treatment.