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Related Experiment Videos

Empyema thoracis: a problem with late referral?

C W Cham1, S M Haq, J Rahamim

  • 1Department of Thoracic Surgery, Derriford Hospital, Plymouth, UK.

Thorax
|September 1, 1993
PubMed
Summary

Delayed surgical treatment for empyema thoracis increases patient morbidity and hospital stay. Early, adequate operative drainage is recommended for better outcomes and reduced complications.

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Area of Science:

  • Thoracic Surgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Empyema management often involves delayed surgical intervention after initial antibiotic treatment.
  • Patients are frequently referred to thoracic units without adequate drainage post-acute phase.

Purpose of the Study:

  • To evaluate the impact of delayed surgical treatment for empyema thoracis on patient morbidity and mortality.
  • To analyze the reasons contributing to delayed referral and its consequences.

Main Methods:

  • A retrospective study of 39 consecutive empyema patients from January 1991 to June 1992.
  • Patients were divided into two groups based on referral time: Group 1 (≤7 days) and Group 2 (>7 days).
  • Reasons for referral delays were analyzed.

Main Results:

  • Delayed referral (Group 2) was associated with increased need for rib resection and decortication.
  • Post-pneumonic empyema was the most common cause, with Staphylococcus aureus frequently isolated.
  • Delayed treatment correlated with longer hospital stays, increased staged procedures, and poorer physiological markers (anemia, low albumin).

Conclusions:

  • Early and adequate operative drainage for empyema thoracis leads to reduced morbidity and shorter hospitalizations.
  • Aggressive management and prompt referral for definitive surgical treatment are crucial for optimal patient outcomes.
  • Delayed surgical intervention negatively impacts patient recovery and increases healthcare resource utilization.

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