The Empyema Thoracis in Samut Prakan Hospital

Authors

  • Monlada Tulachom SamutPrakan Hospital
  • Chawalit Rungnaruethai Samut Prakan hospital

Keywords:

โรคหนองในเยื่อหุ้มปอด, ลอกผนังโพรงหนอง, ใส่สายระบายหนองในเยื่อหุ้มปอด

Abstract

Background : Empyema thoracis is a disease with a high rate of mortality and morbidity. There is a high length of hospital stay and high costs. Therefore, the researcher would like to study and collect patient data to find appropriate treatment and summarize the results of treatment. To develop better treatment.

Objects : Predict outcome for patients with empyema thoracis, and compare outcome between patients who received chest tube drainage before surgery and the patients who had surgery without chest tube drainage.

Method : This is retrospective cohort study from medical records of 37 patients who were diagnosed empyema thoracis at Samut Prakan Hospital from 1 July 2022 to 30 June 2023. Collect data from basic characteristics of patients, treatment options, length of hospital stay and result. Used for statistical analysis.

Results : There were 37 patients, the average age was 56 year, 75%  were male. The leading cause of empyema thoracis was pneumonia (91%). Treatment was decortication 23 cases (62%). 13 (56%) cases were performed without prior ICD. Average time between chest tube drainage to decortication was 8 days. The average length of hospital stay was 16 days. Average length of hospital stay in groups of chest tube drainage with decortication was 29 days and average length of hospital stay in group of decortication alone was 20 days. Two patients were died (5%) with severe septicemia. The patients who received decortication had longer hospital stay than those who did not received decortication (p<0.02)

Conclusion : Empyema thoracis is more common in male than female. Patients had co-morbidities and disabilities before treatment. The quick decision to decortication can reduce length of hospital stay.

Author Biographies

Monlada Tulachom, SamutPrakan Hospital

Department of Medicine

Chawalit Rungnaruethai, Samut Prakan hospital

Department of Medicine

References

Maskell NA, Batt S, Hedley EL, Davies CW, Gillespie SH, Davies RJ. The bacteriology of pleural infection by genetic and standard methods and its mortality significance. Am J Respire Crit Care Med 2006;174(7):817-23.

Finley C, Clifton J, Fitzgerald JM, Yee J. Empyema: an increasing concern in Canada. Can Respire J 2008;15(2):85-9.

Adams F. The genuine works of Hippocrates. Baltimore: Williams & Wilkins; 1939.

Watkins E Jr, Fielder CR. Management of nontuberculous empyema. Surg Clin North Am 1961;41:681-93.

Young WG, Ungerleider RM. Surgical approach to a chronic empyema. In: Deslauriers J, Lacquet LK, editors. Thoracic surgery: surgical management of pleural disease. St. Louis: Mosby; 1990. p. 247-56.

Asciak R, Bedawi EO, Bhatnagar R, Clive AO, Hassan M, Lloyd H, et al. British Thoracic Society Clinical Statement on pleural procedures. Thorax 2023 Jul;78 (Suppl 3):s43-s68.

Maskell NA, Davies CW, Nunn AJ, Hedley EL, Gleeson FV, Miller R, et al. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med 2005;352:865-74.

Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med 2011;365(6):518-26.

Chambers A, Routledge T, Dunning J, Scarci M. Is video-assisted thoracoscopic surgical decortication superior to open surgery in the management of adults with primary empyema? Interact Cardiovasc Thorac Surg 2010;11(2):171-7.

Endoh M, Shiono S. Strategy for surgical treatment of acute thoracic empyema in adults. Curr Chall Thorac Surg 2021;3:4.

Malhotra P, Aggarwal AN, Agarwal R, Ray P, Gupta D, Jindal SK. Clinical characteristics and outcomes of empyema thoracis in 117 patients: A comparative analysis of tuberculous vs. non-tuberculous aetiologies. Respir Med 2007;101:423-30.

Ferguson AD, Prescott RJ, Selkon JB, Watson D, Swinburn CR. The clinical course and management of thoracic empyema. QJM 1996;89:285-9.

Nwiloh J, Freeman H, McCord C. Malnutrition: an important determinant of fatal outcome in surgically treated pulmonary suppurative disease. J Natl Med Assoc 1989;81(5):525-9.

Chaitra KM, Mohan Kumar N, Saipraneeth Reddy G. Hyponatremia in lower respiratory tract infections. International Journal of Contemporary Pediatrics 2016;3(2):381-4.

Glinjongol Ch. Management of empyema thoracis in Ratchaburi Hospital. Region7 Medical Journal 1992;1:5-14.

Ronchetto F, Pistono PG, Stacchini E, Guasco C. Thoracic empyema caused by anaerobes. 78-month retrospective study. Clinical and microbiological aspects. G Batteriol Virol Immunol 1992;85(1-12):26-34.

Lappikulthong A, Glinjongol C, Vongsangcom Y. Factors affected the length of hospital stay of surgical empyema thoracis patient at Ratchaburi hospital. Region 4-5 Medical journal 2017;36(2):71-7.

Elsayed HH, Mostafa A, Fathy E, Diab HS, Nofal IM, AbdelHamid OA, et.al. Thoracoscopic management of early stages of empyema: is this the gold standard? J Vis Surg 2018;4:114.

Downloads

Published

2024-05-01 — Updated on 2024-05-18

Versions