Risk Factors for Empyema Following Penetrating Diaphragmatic Injuries.

Area of Science:

• Trauma Surgery
• Thoracic Surgery
• Infectious Disease

Background:

• Empyema is a known complication of chest trauma.
• Penetrating diaphragmatic injuries present unique challenges in trauma management.
• Risk factors for empyema following diaphragmatic trauma require further elucidation.

Purpose of the Study:

• To identify risk factors for empyema in patients with penetrating diaphragmatic injuries.
• To analyze the association between specific injury characteristics and empyema development.
• To understand the impact of empyema on patient outcomes.

Main Methods:

• Retrospective analysis of consecutive adult trauma patients with penetrating diaphragmatic injuries.
• Data collection included demographics, injury details, interventions, and complications.
• Univariate analyses were performed to compare patients with and without empyema.

Main Results:

• 10.4% of patients (17/164) developed empyema.
• Empyema was significantly associated with visible abdominal contamination (P=.04) and thoracotomy (P=.03).
• Empyema correlated with higher rates of pneumonia (P=.01), sepsis (P=.006), and longer hospital/ICU stays, but lower in-hospital mortality (P=.04).

Conclusions:

• Visible abdominal contamination and thoracotomy are significant risk factors for empyema after penetrating diaphragmatic injuries.
• Empyema development in this population is linked to increased resource utilization and complications, yet paradoxically, lower mortality.
• Further research into preventative strategies and management protocols for empyema in penetrating diaphragmatic trauma is warranted.