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Related Experiment Video

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Measurement of Bioelectric Current with a Vibrating Probe
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Current State of Empyema Management.

Tara R Semenkovich1, Margaret A Olsen2, Varun Puri1

  • 1Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri.

The Annals of Thoracic Surgery
|March 19, 2018
PubMed
Summary

Chest tube drainage for empyema leads to higher readmission and reintervention rates. Earlier surgical intervention may improve outcomes for some patients with this serious condition.

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Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Healthcare Outcomes Research

Background:

  • Empyema impacts a significant number of patients annually in the US, with current treatment guidelines lacking clarity on optimal management.
  • Ambiguity in consensus guidelines necessitates further research into effective empyema treatment strategies.

Purpose of the Study:

  • To examine current inpatient treatment practices and outcomes for empyema.
  • To compare treatment outcomes, including success rates, readmission, reintervention, and mortality, across different empyema interventions.

Main Methods:

  • Utilized the New York State Inpatient Database (2009-2014) for a statewide cohort of hospitalized empyema patients.
  • Categorized patients into three groups based on definitive treatment: chest tube drainage, video-assisted thoracoscopic surgery (VATS) decortication, or open decortication.
  • Compared outcomes such as mortality, readmission, and reintervention rates between the treatment groups.

Main Results:

  • A cohort of 4,095 patients undergoing intervention for primary empyema was analyzed.
  • Higher initial hospitalization mortality was observed with chest tube drainage (15.4%) compared to VATS (4.7%) and open decortication (6.0%).
  • Chest tube management was associated with significantly higher 30-day empyema readmission (7.3%) and reintervention rates (6.1%) compared to surgical approaches.

Conclusions:

  • Chest tube drainage for empyema is linked to increased rates of readmission and reintervention.
  • Findings suggest that some patients treated with chest tubes may benefit from earlier, definitive surgical intervention for empyema.
  • This study highlights the need for refined treatment algorithms for empyema management.