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KMID : 0383820070630010024
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Tuberculosis and Respiratory Diseases
2007 Volume.63 No. 1 p.24 ~ p.30
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Treatment Results and Prognostic Factors of Complicated Parapneumonic Effusion and Empyema
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Kim Yong-Joo
Chun Hee-Jung
Cha Seung-Ick
Kwon Ji-Suk
You Seung-Soo
Kim Chang-Ho
Park Jae-Yong
Jung Tae-Hoon
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Abstract
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Background: Pleural effusion develops in approximately 40% of pneumonia patients. In 5-10% of these cases, it progresses to complicated parapneumonic effusion (CPPE) or empyema that requires drainage. The prognostic factors of CPPE and empyema remain to be clarified. We examined the treatment outcomes of CPPE and empyema and elucidating their prognostic factors.
Methods: One hundred and fifteen patients with CPPE or empyema, who were diagnosed and treated in Kyungpook National University Hospital (Daegu, Korea) between September 2001 and December 2005, were retrospectively analyzed. All the data was acquired from their chart review, and regarding treatment results, the time to defervescence and the length of hospital stay were analyzed.
Results: The treatment was successful in 101 patients with a success rate of 87.8%. Multivariate analysis showed the level of pleural fluid lactate dehydrogenase (LDH) to be a significant prognostic factor (odds ratio [OR] 7.37; 95% confidence interval [CI], 1.63 to 33.37; p=0.009). Pussy pleural fluid (r=0.236; p=0.01) and the frequency of urokinase use (r=0.257; p=0.01) correlated with the time to defervescence. However, there was no clinical factor that correlated with the length of hospital stay.
Conclusion: The pleural fluid LDH level is a useful prognostic factor for monitoring treatment results of CPPE and empyema.
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KEYWORD
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Empyema, Lactate dehydrogenase, Pleural effusion, Pneumonia, Prognosis
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