Risk factors for parapneumonic effusion in community-asquired pneumonia

Abstract

20–40% of patients hospitalized for community-acquired pneumonia develop parapneumonic effusion.

Aim: to identify factors associated with development of parapneumonic effusion in hospitalized patients with community-acquired pneumonia.

Methods: case control study. From 499 patients with community-acquired pneumonia hospitalized at the Pulmonary Department of Moscow Hospital in 2017 year, 74 developed parapneumonic effusion (14,82%). The case group is 60 patients with community-acquired pneumonia with parapneumonic effusion with median age of 58 years (47.25-74), 34 male. The matched control group is 60 patients with community-acquired pneumonia without parapneumonic effusion, median of age 55 years (32.5- 69), 30 male. Exclusion criteria: cancer, tuberculosis, pulmonary embolism. 14 patients were excluded. Statistical analysis was performed using the IBM SPSS Statistics 23. Data presents at median (25-75 percentile).

Results: Number of days from the onset of the disease to the start of antibiotic therapy was found to differ significantly between the case and control group, 6 days (3-9.5) vs 3.5 days (2-7) (p = 0.042), respectively. The frequency of bilateral pneumonia in the case group was 26.6%, in the control group was11.6% (p <0.05). Patients of the case group have been receiving antibiotic treatment longer than patients from the control group 13,3 days (9.5–17 ) vs 9 days (7–12 ) (p = 0.001), this significantly increased the duration of hospitalization 15.5 days (12-20) vs 11 days (9-14);( p = 0.003).

Conclusion: Late prescription of antibiotics may contribute to the development of parapneumonic effusion in patients with community-acquired pneumonia.