Tuberc Respir Dis.  2007 Jul;63(1):24-30. 10.4046/trd.2007.63.1.24.

Treatment Results and Prognostic Factors of Complicated Parapneumonic Effusion and Empyema

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sicha@knu.ac.kr

Abstract

BACKGROUND: Pleural effusion develops in approximately 40% of pneumonia patients. In 5-10% of these cases, it progresses to complicated parapneumonic effusion (CPPE) or empyema that requires drainage. The prognostic factors of CPPE and empyema remain to be clarified. We examined the treatment outcomes of CPPE and empyema and elucidating their prognostic factors.
METHODS
One hundred and fifteen patients with CPPE or empyema, who were diagnosed and treated in Kyungpook National University Hospital (Daegu, Korea) between September 2001 and December 2005, were retrospectively analyzed. All the data was acquired from their chart review, and regarding treatment results, the time to defervescence and the length of hospital stay were analyzed.
RESULTS
The treatment was successful in 101 patients with a success rate of 87.8%. Multivariate analysis showed the level of pleural fluid lactate dehydrogenase (LDH) to be a significant prognostic factor (odds ratio [OR] 7.37; 95% confidence interval [CI], 1.63 to 33.37; p=0.009). Pussy pleural fluid (r=0.236; p=0.01) and the frequency of urokinase use (r=0.257; p=0.01) correlated with the time to defervescence. However, there was no clinical factor that correlated with the length of hospital stay.
CONCLUSION
The pleural fluid LDH level is a useful prognostic factor for monitoring treatment results of CPPE and empyema.

Keyword

Empyema; Lactate dehydrogenase; Pleural effusion; Pneumonia; Prognosis
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