Indicators for surgical intervention in thoracic empyema in children
Hamdi H Almaramhy1, Amr M Allama
1Surgery Department, Faculty of Medicine, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail. maramhy@hotmail.com.
Saudi Medical Journal
|August 31, 2015
Summary
Predictors for surgical intervention in pediatric thoracic empyema were investigated. Absence of fever was the only variable associated with thoracotomy, suggesting delayed treatment rather than a direct indicator for surgery.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Infectious Diseases
Background:
- Thoracic empyema in children requires effective treatment strategies.
- Identifying predictors for surgical intervention is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine predictors for surgical intervention in pediatric thoracic empyema.
- To assess the morbidity associated with surgical treatment.
Main Methods:
- Retrospective review of 62 pediatric empyema cases (2007-2012).
- Patients were divided into chest tube (CT) insertion (51) and thoracotomy (TH) (11) groups.
- Comparison of clinical, demographic, and radiological data to identify predictors for thoracotomy.
Main Results:
- No significant differences in age, lesion side, cough, or dyspnea between groups.
- Thoracotomy group showed longer duration of complaint (13.5 vs 10 days), higher fever (90.2% vs 36.4%), and recurrent chest infections (90.9% vs 37.3%).
- Absence of fever was significantly less common in the thoracotomy group, potentially indicating delayed referral.
Conclusions:
- No definitive predictor for surgical intervention was identified.
- Absence of fever may suggest delayed treatment and prolonged antibiotic use, warranting cautious interpretation as a surgical indicator.
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