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Posttraumatic empyema. Risk factor analysis

M M Aguilar1, F D Battistella, J T Owings

  • 1Department of Surgery, University of California, Medical Center, Davis, USA.

Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1997
PubMed
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Pulmonary contusion and retained hemothorax are key risk factors for developing empyema after thoracic injury. Early pleural space drainage using video-assisted thoracoscopy is recommended for at-risk patients to reduce morbidity.

Area of Science:

  • Thoracic surgery
  • Trauma surgery
  • Infectious disease

Background:

  • Empyema is a serious complication following thoracic trauma.
  • Identifying risk factors is crucial for timely intervention.

Purpose of the Study:

  • To identify predictors of post-traumatic empyema development.
  • To evaluate factors influencing empyema after thoracic injury.

Main Methods:

  • Retrospective cohort review of 584 trauma patients requiring tube thoracostomy (TT).
  • Stepwise logistic regression analysis to determine risk factors for empyema.
  • Data included demographics, injuries, and TT specifics.

Main Results:

  • Empyema requiring decortication occurred in 4% of patients.

Related Experiment Videos

  • Predictive factors for empyema included retained hemothorax (OR 12.5) and pulmonary contusion (OR 6.3).
  • Multiple chest tube placement was also a risk factor (OR 2.5).

    • Conclusions:

    • Pulmonary contusion is a significant predictor of empyema.
    • Mechanism of injury and TT setting were not predictive.
    • Recommend early pleural space drainage via video-assisted thoracoscopy for high-risk patients.