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Risk factors for the development of pleural empyema in children

Mohamed A Elemraid1,2, Matthew F Thomas3,4, Alasdair P Blain3

  • 1Department of Paediatric Infectious Disease and Immunology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Pediatric Pulmonology
|April 3, 2014
PubMed

Insights

Pediatric pleural empyema is rising, with ibuprofen use and bacterial infection identified as key risk factors in children with pneumonia. Further research is needed to understand ibuprofen

Area of Science:

  • Pediatric Infectious Diseases
  • Pulmonary Medicine
  • Epidemiology

Background:

  • Pediatric pleural empyema incidence has significantly increased over the last two decades.
  • The underlying reasons for this rise in childhood empyema are not fully understood.

Purpose of the Study:

  • To investigate potential risk factors associated with the development of empyema in children hospitalized with community-acquired pneumonia.
  • To analyze demographic, clinical, socioeconomic, and epidemiological factors, including ibuprofen use, in pediatric empyema cases.

Main Methods:

  • Prospective etiological study of 160 hospitalized children (≤16 years) with radiologically confirmed pneumonia.
  • Data collection included patient demographics, clinical presentation, pre-hospitalization medication use (ibuprofen), and potential risk factors.
  • Statistical analysis, including odds ratios (OR) with 97.5% credible intervals, was used to compare children with and without empyema.

Main Results:

  • Empyema developed in 25% (40/160) of the children.
  • Children who developed empyema were more likely to have received ibuprofen prior to hospital admission (82% vs. 46.2%; OR 1.94).
  • Confirmed bacterial infection was strongly associated with empyema development (OR 3.34). Age, sex, socioeconomic status, and parental smoking were not significant risk factors.

Conclusions:

  • Pre-hospitalization ibuprofen use and confirmed bacterial infection are associated with the development of empyema in children with pneumonia.
  • Further population-based studies are recommended to explore the role of ibuprofen in modulating disease course in pediatric pneumonia.

Keywords:
Ibuprofenempyemapediatricspneumoniarisk factors

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