Video-Assisted Thoracoscopic Surgery in Community-Acquired Thoracic Empyema: Analysis of Risk Factors for Mortality.
Surg Infect (Larchmt)
; 23(2): 191-198, 2022 Mar.
Article
em En
| MEDLINE
| ID: mdl-35085460
ABSTRACT
Background:
Thoracic empyema is a disease with high mortality and morbidity. Video-assisted thoracoscopic surgery (VATS) is recommended to treat advanced stage empyema. The purpose of this study was to explore risk factors associated with post-surgery mortality for community-acquired empyema. Patients andMethods:
We retrospectively reviewed 440 patients who received VATS for community-acquired empyema, higher than stage 2, in a tertiary medical center in Taiwan. Patients' age, comorbidities, pleural effusion analysis, and post-surgery outcome were compiled. Cox regression model for survival was applied to identify risk factors of 90-day death after surgery.Results:
Fifty-three patients (12.05%) had died within 90 days post-surgery. The risk factors of mortality were advanced age (hazard ratio [HR], 1.027; 95% confidence interval [CI], 1.001-1.052), chronic kidney disease (HR, 5.322; 95% CI, 2.635-10.746), cancer (HR, 6.038; 95% CI, 2.737-13.321), pleural effusion pH ≤7 (HR, 2.61; 95% CI, 1.344-5.069), pleural effusion protein ≤4 (HR, 2.021; 95% CI, 1.035-3.947), and late surgery (HR, 3.014; 95% CI, 1.595-5.696). The 90-day mortality in the early surgery group versus the late group was 6.85% versus 26.05%. The increased mortality risk from late surgery was observed in most subgroups, except for patients who were female, had chronic renal disease, and had coronary artery disease.Conclusions:
Patients who are elderly, have chronic kidney disease, cancer history, low pleural effusion pH, low pleural effusion protein, and late surgery are associated with post-surgery mortality for community-acquired advanced empyema. Early VATS surgery for advanced empyema or treatment failure of chest tube drainage appears to beneficial and is recommended.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Empiema Pleural
/
Cirurgia Torácica Vídeoassistida
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article