Predicting factors for outcome of tube thoracostomy in complicated parapneumonic effusion or empyema

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Abstract

Study objectives: To determine the predicting factors for outcome of tube thoracostomy in patients with complicated parapneumonic effusion (CPE) or empyema. Design and settings: Retrospective chart review over a 55-month period at a tertiary referred medical center. Patients and measurements: The medical charts of patients with empyema or CPE were reviewed. Data including age, gender, clinical symptoms, important underlying diseases, leukocyte count, duration of preadmission symptoms, interval from first procedure to second procedure, the time from first procedure to discharge (recovery time), the amount of effusion drained, administration of intrapleural streptokinase, chest tube size and position, loculation of pleural effusion, and characteristics and culture results of pleural effusion were recorded and compared between groups of patients with successful and failed outcome of tube thoracostomy drainage. Results: One hundred twenty-one patients were selected for study. One hundred of these patients had received tube thoracostomy drainage with 53 successful outcomes and 47 failed outcomes of chest tube drainage. Nineteen patients received decortication directly, and the other two received antibiotics alone. Univariate analysis showed that pleural effusion leukocyte count, effusion amount, and loculation of pleural effusion were significantly related to the outcome of chest tube drainage. Multiple logistic regression analysis demonstrated that loculation and pleural effusion leukocyte count ≤6,400/μL were the only independent predicting factors related to failure of tube thoracostomy drainage. Conclusions: Loculation and pleural effusion leukocyte count ≤ 6,400/μL were independent predicting factors of poor outcome of tube thoracostomy drainage. These results suggest that if the initial attempt at chest tube drainage fails early surgical intervention should be considered in good surgical candidates with loculated empyema or pleural effusion with leukocyte count ≤ 6,400/μL.

Original languageEnglish
Pages (from-to)751-756
Number of pages6
JournalChest
Volume115
Issue number3
DOIs
Publication statusPublished - 1999 Jan 1

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Thoracostomy
Empyema
Pleural Effusion
Drainage
Chest Tubes
Leukocyte Count
Streptokinase
Logistic Models
Regression Analysis
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Predicting factors for outcome of tube thoracostomy in complicated parapneumonic effusion or empyema",
abstract = "Study objectives: To determine the predicting factors for outcome of tube thoracostomy in patients with complicated parapneumonic effusion (CPE) or empyema. Design and settings: Retrospective chart review over a 55-month period at a tertiary referred medical center. Patients and measurements: The medical charts of patients with empyema or CPE were reviewed. Data including age, gender, clinical symptoms, important underlying diseases, leukocyte count, duration of preadmission symptoms, interval from first procedure to second procedure, the time from first procedure to discharge (recovery time), the amount of effusion drained, administration of intrapleural streptokinase, chest tube size and position, loculation of pleural effusion, and characteristics and culture results of pleural effusion were recorded and compared between groups of patients with successful and failed outcome of tube thoracostomy drainage. Results: One hundred twenty-one patients were selected for study. One hundred of these patients had received tube thoracostomy drainage with 53 successful outcomes and 47 failed outcomes of chest tube drainage. Nineteen patients received decortication directly, and the other two received antibiotics alone. Univariate analysis showed that pleural effusion leukocyte count, effusion amount, and loculation of pleural effusion were significantly related to the outcome of chest tube drainage. Multiple logistic regression analysis demonstrated that loculation and pleural effusion leukocyte count ≤6,400/μL were the only independent predicting factors related to failure of tube thoracostomy drainage. Conclusions: Loculation and pleural effusion leukocyte count ≤ 6,400/μL were independent predicting factors of poor outcome of tube thoracostomy drainage. These results suggest that if the initial attempt at chest tube drainage fails early surgical intervention should be considered in good surgical candidates with loculated empyema or pleural effusion with leukocyte count ≤ 6,400/μL.",
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Predicting factors for outcome of tube thoracostomy in complicated parapneumonic effusion or empyema. / Huang, Hsu Chia; Chang, Han-Yu; Chen, Chang-Wen; Lee, Cheng-Hung; Hsiue, Tzuen-Ren.

In: Chest, Vol. 115, No. 3, 01.01.1999, p. 751-756.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predicting factors for outcome of tube thoracostomy in complicated parapneumonic effusion or empyema

AU - Huang, Hsu Chia

AU - Chang, Han-Yu

AU - Chen, Chang-Wen

AU - Lee, Cheng-Hung

AU - Hsiue, Tzuen-Ren

PY - 1999/1/1

Y1 - 1999/1/1

N2 - Study objectives: To determine the predicting factors for outcome of tube thoracostomy in patients with complicated parapneumonic effusion (CPE) or empyema. Design and settings: Retrospective chart review over a 55-month period at a tertiary referred medical center. Patients and measurements: The medical charts of patients with empyema or CPE were reviewed. Data including age, gender, clinical symptoms, important underlying diseases, leukocyte count, duration of preadmission symptoms, interval from first procedure to second procedure, the time from first procedure to discharge (recovery time), the amount of effusion drained, administration of intrapleural streptokinase, chest tube size and position, loculation of pleural effusion, and characteristics and culture results of pleural effusion were recorded and compared between groups of patients with successful and failed outcome of tube thoracostomy drainage. Results: One hundred twenty-one patients were selected for study. One hundred of these patients had received tube thoracostomy drainage with 53 successful outcomes and 47 failed outcomes of chest tube drainage. Nineteen patients received decortication directly, and the other two received antibiotics alone. Univariate analysis showed that pleural effusion leukocyte count, effusion amount, and loculation of pleural effusion were significantly related to the outcome of chest tube drainage. Multiple logistic regression analysis demonstrated that loculation and pleural effusion leukocyte count ≤6,400/μL were the only independent predicting factors related to failure of tube thoracostomy drainage. Conclusions: Loculation and pleural effusion leukocyte count ≤ 6,400/μL were independent predicting factors of poor outcome of tube thoracostomy drainage. These results suggest that if the initial attempt at chest tube drainage fails early surgical intervention should be considered in good surgical candidates with loculated empyema or pleural effusion with leukocyte count ≤ 6,400/μL.

AB - Study objectives: To determine the predicting factors for outcome of tube thoracostomy in patients with complicated parapneumonic effusion (CPE) or empyema. Design and settings: Retrospective chart review over a 55-month period at a tertiary referred medical center. Patients and measurements: The medical charts of patients with empyema or CPE were reviewed. Data including age, gender, clinical symptoms, important underlying diseases, leukocyte count, duration of preadmission symptoms, interval from first procedure to second procedure, the time from first procedure to discharge (recovery time), the amount of effusion drained, administration of intrapleural streptokinase, chest tube size and position, loculation of pleural effusion, and characteristics and culture results of pleural effusion were recorded and compared between groups of patients with successful and failed outcome of tube thoracostomy drainage. Results: One hundred twenty-one patients were selected for study. One hundred of these patients had received tube thoracostomy drainage with 53 successful outcomes and 47 failed outcomes of chest tube drainage. Nineteen patients received decortication directly, and the other two received antibiotics alone. Univariate analysis showed that pleural effusion leukocyte count, effusion amount, and loculation of pleural effusion were significantly related to the outcome of chest tube drainage. Multiple logistic regression analysis demonstrated that loculation and pleural effusion leukocyte count ≤6,400/μL were the only independent predicting factors related to failure of tube thoracostomy drainage. Conclusions: Loculation and pleural effusion leukocyte count ≤ 6,400/μL were independent predicting factors of poor outcome of tube thoracostomy drainage. These results suggest that if the initial attempt at chest tube drainage fails early surgical intervention should be considered in good surgical candidates with loculated empyema or pleural effusion with leukocyte count ≤ 6,400/μL.

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