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World Journal of Surgery

, Volume 34, Issue 2, pp 266–271 | Cite as

Poor Late Survival After Surgical Treatment of Pleural Empyema

  • Reija Mikkola
  • Janna Kelahaara
  • Jouni Heikkinen
  • Jarmo Lahtinen
  • Fausto BiancariEmail author
Article

Abstract

Background

We have evaluated the outcome of patients who underwent surgical treatment of parapneumonic pleural empyema.

Methods

This study included 143 consecutive patients older than 18 years who were operated on for parapneumonic pleural empyema.

Results

The overall survival at 30 days, 3 months, 5 years, and 10 years was 97.2, 92.3, 80.6, and 61.9%, respectively. Serum albumin (OR = 0.78, 95% CI = 0.65-0.94), cerebrovascular disease (OR = 30.49, 95% CI = 1.35-689.05), pulmonary embolism (OR = 984.63, 95% CI = 7.81-124206.8), and Thoracoscore (OR = 1.61, 95% CI = 1.10-2.35) were independent predictors of 3-month overall survival. Age (RR = 1.08, 95% CI = 1.03-1.14), serum albumin (RR = 0.89, 95% CI = 0.82-0.98), chronic obstructive pulmonary disease (COPD) (RR = 5.14, 95% CI = 1.3319.84), and cerebrovascular disease (RR = 6.76, 95% CI = 1.33-34.34) were independent predictors of pneumonia/pleural empyema-related death. Twenty-two patients required 33 reinterventions after the primary procedure: 19 patients after primary thoracoscopy and 3 patients after primary thoracotomy. Reintervention did not have any significant impact on 30-day mortality (4.5% vs. 2.5%, p = 0.49), but it affected 3-month mortality (26.1% vs. 4.2%, p < 0.0001). Reoperation was an independent predictor of late overall survival (at 10 years: 35.5% vs. 67.4%, RR = 2.95, 95% CI = 1.33-6.57) and freedom from pneumonia/pleural empyema-related death (at 10 years: 73.9% vs. 91.3%, RR = 4.40, 95% CI = 1.24-15.66).

Conclusions

Surgical treatment of pleural empyema can be associated with good immediate results, but longer follow-up showed that pneumonia/pleural empyema-related mortality and all-cause mortality are rather poor.

Keywords

Chronic Obstructive Pulmonary Disease Pulmonary Embolism Receiver Operate Characteristic Curve Pleural Fluid Late Mortality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This study was supported by a grant from the Väinö and Laina Kivi Foundation, Finland.

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Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Reija Mikkola
    • 1
  • Janna Kelahaara
    • 1
  • Jouni Heikkinen
    • 1
  • Jarmo Lahtinen
    • 1
  • Fausto Biancari
    • 1
    Email author
  1. 1.Division of Cardio-thoracic and Vascular Surgery, Department of SurgeryOulu University HospitalOuluFinland

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