Factors Influencing Length of Hospital Stay in Patients with Bacterial Pleural Effusion

Soriano, Teresa; Alegre, José; Alemán, Carmen; Ruiz, Elvira Medina; Vázquez, A.; Segura, Ramón; Ferrer, Adelaida; Sevilla, Tomàs Fernández de

doi:10.1159/000087366

Cited by 18 publications

(17 citation statements)

References 36 publications

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“…The negative CR group had significantly lower incidences of complicated parapneumonic effusion or empyema and pleural drainage than the control group. Previous studies have suggested that complicated parapneumonic effusion or empyema could prolong the LOS in hospitalized CAP patients [23, 24]. This can partly explain the shorter LOS in the negative CR group in our study.…”

Section: Discussionsupporting

confidence: 53%

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

et al. 2019

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Background: Data regarding community-acquired pneumonia (CAP) identified on chest computed tomography (CT) but not on chest radiography (CR) are limited. Objectives: The present study aimed to investigate the clinical and radiological features of these patients. Methods: We retrospectively compared the clinical characteristics, etiological agents, treatment outcomes, and CT findings between CAP patients with negative CR and positive CT findings (negative CR group) and those with positive CR as well as CT findings (control group). Results: Of 1,925 patients, 94 patients (4.9%) were included in the negative CR group. Negative CR findings could be attributed to the location of the lesions (e.g., those located in the dependent lung) and CT pattern with a low attenuation, such as ground-glass opacity (GGO). The negative CR group was characterized by a higher frequency of aspiration pneumonia, lower incidences of complicated parapneumonic effusion or empyema and pleural drainage, and lower blood levels of inflammatory markers than the control group. On CT, the negative CR group exhibited higher rates of GGO- and bronchiolitis-predominant patterns and a lower rate of consolidation pattern. Despite shorter length of hospital stay in the negative CR group, 30-day and in-hospital mortalities were similar between the two groups. Conclusions: CAP patients with negative CR findings are characterized by lower blood levels of inflammatory markers, a higher incidence of aspiration pneumonia, and a lower incidence of complicated parapneumonic effusion or empyema than those with positive CR findings. Chest CT scan should be considered in suspected CAP patients with a negative CR, especially in bedridden patients.

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Section: Discussionsupporting

confidence: 53%

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

et al. 2019

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“…11,12 There are some patients for whom initial treatment is not possible and in whom chronic empyema will develop, mainly due to delayed diagnosis or late referral. At this stage, the standard treatment is open thoracotomy and decortication.…”

Section: Discussionmentioning

confidence: 99%

“…At this stage, the standard treatment is open thoracotomy and decortication. Historically, other surgical procedures have been practiced, including open window thoracotomy, rib resection, thoracoplasty, Claggett's procedure and percutaneous drainage guided by ultrasound or CT. [11][12][13] With the increasing popularity of minimally access surgery, video-thoracoscopy has been proposed for the treatment of chronic empyema. 13 There are reports in which open procedures have shown higher morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Several reports from thoracic surgeons quote thoracotomy and decortication is the best treatment for chronic empyema especially in stage of fibrothorax. [10][11][12] We reviewed our experience with thoracotomy and decortication in the management of chronic empyema, (fibrothorax) focusing on morbidity, mortality, postoperative management, and functional results.…”

Section: Introductionmentioning

confidence: 99%

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Thoracotomy and decortication in chronic empyema (fibrothorax), in the era of video assisted thoracic surgery

2017

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Background: Traditionally, open thoracotomy and decortication with or without pleurectomy is the treatment of chronic empyema in the stage of fibrothorax. Some recent reports have claimed similar clinical results by video assisted thoracoscopic surgery (VATS) with less morbidity and mortality than open surgery. Our experience with thoracotomy and decortication with or without pleurectomy for fibrothorax is reviewed, in this study. Aim was to evaluate results of the results of open thoracotomy and decortication with or without pleurectomy in patients with chronic empyema in the stage of fibrothorax.Methods: From September 2007 to March 2012, 126 patients with diagnosis of empyema thoracic were treated at institute. Diagnosis of chronic empyema was based on-duration of signs and symptoms before definitive treatment and imaging findings- such as constriction of thoracic cage and lungs. 56 patients fulfilled the criteria for chronic empyema and then underwent open thoracotomy and decortication.Results: 39 patients (69.6 %) were males, 17 patients (30.35 %) were females. Mean age of study group was 31.4 years. Etiology was synpneumonic effusion in 49 patients (87.5 %) sub pleural malignancy in 3 patients, traumatic haemothorax in 2 patients and ruptured hydatid cyst in 2 patients. The mean duration of symptoms and signs before definitive treatment averaged 42 days. All patients had chronic empyema (Fibrothorax), as confirmed by imaging and operative findings. There were 3 patients (5.4 %) with complications and one mortality. The postoperative length of stay averaged 11.2 days. There were no recurrences of empyema. Complete expansion of lung was confirmed by imaging in 53 patients at the end of 3 months on follow up.Conclusions: Treatment for chronic empyema thoracic with Fibrothorax can be achieved with open thoracotomy and decortication with low complication rates and low mortality with satisfactory results.

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“…It is generally accepted that pleural empyema should be treated early to avoid complications, extensive operations and lengthy hospital stays. 6, 16 Unfortunately, there are some patients for whom early treatment is not possible and in whom chronic empyema will develop, mainly due to delayed diagnosis or delayed referral. At this stage, the standard treatment is open thoracotomy and decortication.…”

Section: Discussionmentioning

confidence: 99%

Open Thoracotomy and Decortication for Chronic Empyema (Fibrothorax)

Nichkaode¹,

Dasgupta²,

Zamad³

et al. 2013

jemds

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OBJECTIVES AND AIMS: Traditionally, chronic empyema has been treated by thoracotomy and decortication. Some recent reports have claimed similar clinical results for video thoracoscopy, but with less morbidity and mortality than open procedures. Our experience with thoracotomy and decortication in patients in fibrothorax stage is reviewed so that the results of this surgical procedure can be adequately evaluated. MATERIALS AND METHODS: From September 2007 to march 2012, 126 patients diagnosed with empyema thoracis were treated in NKP Salve Institute of medical sciences. Diagnosis of chronic empyema was based on the duration of signs and symptoms before definitive treatment and imaging findings, such as constriction of the lungs and the thoracic cage. Fifty six patients fulfilled the criteria for chronic empyema and underwent open thoracotomy and decortication. RESULTS AND STATISTICS: Thirty nine patients (69.6%) were males and the mean age of study group was 31.4 years. Etiology was synpneumonic effusion in 49 patients (87.5%), subpleural malignancy in 3 patients, traumatic haemothorax in 2 patients and ruptured hydatid cyst in 2 patients . The mean duration of symptoms and signs before definitive treatment averaged 42 days. All patients had chronic empyema, as confirmed by imaging studies and operative findings. There were 3 patients (5.4%) with complications and one mortality. The postoperative length of stay averaged 11.2 days. There were no recurrences of empyema. Complete expansion of lung was noticed in 53 patients at end of 3 months on follow up. CONCLUSION: Treatment for patients with chronic empyema thoracis with fibrothorax can be achieved with Open thoracotomy and decortication with low complication rates and low mortality with good results.

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Factors Influencing Length of Hospital Stay in Patients with Bacterial Pleural Effusion

Cited by 18 publications

References 36 publications

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

Community-Acquired Pneumonia with Negative Chest Radiography Findings: Clinical and Radiological Features

Thoracotomy and decortication in chronic empyema (fibrothorax), in the era of video assisted thoracic surgery

Open Thoracotomy and Decortication for Chronic Empyema (Fibrothorax)

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