TO DETERMINE THE FACTORS PROMOTING FAVOURABLE TREATMENT OUTCOME OF EMPYEMA THORACIS AND COMPLICATED PARAPNEUMONIC EFFUSION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 4
Abstract
BACKGROUND The annual incidence of bacterial pneumonia is quite high with 40% of hospitalised patients have accompanying pleural effusion. The morbidity and mortality rates in patients with pneumonia and pleural effusions are higher than those in patients with pneumonia alone. Early drainage of pus from the pleural cavity along with broad-spectrum antibiotics still remains the cornerstone of treatment. Very few earlier studies have focused on the predicting factors for favourable outcome of parapneumonic effusion and empyema. MATERIALS AND METHODS Study Design- A prospective study. A total of 61 patients with diagnosis of complicated parapneumonic effusion and empyema were enrolled. Patient’s characteristics, comorbidities, duration of symptoms, pleural fluid characteristics and radiological features were noted. All cases were treated with either large bore or small bore chest tubes to drain pleural fluid. Intrapleural Streptokinase was instilled in non-responding patients. Their relation to treatment outcome was evaluated using non-parametric Mann-Whitney U test, Chi-square technique and Fisher’s exact test. RESULTS No significant relation exists between presence of comorbidity and outcome; though diabetic patients, smokers and alcoholics had comparatively poorer outcome. All bore pigtail catheters are effective in management of complicated parapneumonic effusion and loculated empyema. Intrapleural streptokinase increases drainage and improves clinical and radiological outcome. Duration of presenting symptom correlates with outcome of tube thoracostomy. CONCLUSION All cases of empyema complicated by bronchopleural fistula are difficult to manage and need surgery.
Authors and Affiliations
Seema K, Vijay Nair
Keywords
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- EP ID EP285813
- DOI 10.14260/jemds/2018/95
- Views 79
- Downloads 0
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