OBJECTIVES: To compare the clinical characteristics of community-acquired thoracic empyema in older and younger patients and to analyze the effect of various factors on outcome. DESIGN: A retrospective, comparative observational study. SETTING: A university-affiliated tertiary medical center. PARTICIPANTS: Forty-six patients aged 65 and older (older group) and 86 patients aged 18 to 64 (younger group). MEASUREMENTS: Demographic, clinical, and microbiological data were reviewed. RESULTS: Older patients were more likely to have dyspnea but less likely to have chest pain or fever (P<.05 for all). The causative organisms were similar between the two groups, with anaerobes and facultative streptococci the most common pathogens. Older patients had increased morbidity and longer hospital stay (median 29.5 vs 20 days, P<.001), but the in-hospital mortality was not significantly different between the two groups (13% vs 8%, P=.37). Multivariate analysis showed that coexisting malignancy (odds ratio (OR)=10.33, P=.01), lack of fever higher than 38 degrees C (OR=17.97, P=.03), and isolation of fungi from pleural fluid (OR=32.66, P=.01) were independently and significantly associated with in-hospital deaths. CONCLUSION: The microbiology and mortality of community-acquired thoracic empyema were similar between the two age groups. Difference in chronological age did not explain in-hospital death. This finding highlights the importance of effective treatment to obtain better outcomes for older patients.
OBJECTIVES: To compare the clinical characteristics of community-acquired thoracic empyema in older and younger patients and to analyze the effect of various factors on outcome. DESIGN: A retrospective, comparative observational study. SETTING: A university-affiliated tertiary medical center. PARTICIPANTS: Forty-six patients aged 65 and older (older group) and 86 patients aged 18 to 64 (younger group). MEASUREMENTS: Demographic, clinical, and microbiological data were reviewed. RESULTS: Older patients were more likely to have dyspnea but less likely to have chest pain or fever (P<.05 for all). The causative organisms were similar between the two groups, with anaerobes and facultative streptococci the most common pathogens. Older patients had increased morbidity and longer hospital stay (median 29.5 vs 20 days, P<.001), but the in-hospital mortality was not significantly different between the two groups (13% vs 8%, P=.37). Multivariate analysis showed that coexisting malignancy (odds ratio (OR)=10.33, P=.01), lack of fever higher than 38 degrees C (OR=17.97, P=.03), and isolation of fungi from pleural fluid (OR=32.66, P=.01) were independently and significantly associated with in-hospital deaths. CONCLUSION: The microbiology and mortality of community-acquired thoracic empyema were similar between the two age groups. Difference in chronological age did not explain in-hospital death. This finding highlights the importance of effective treatment to obtain better outcomes for older patients.
Authors: Paolo Nicola Camillo Girotti; Peter Tschann; Paolo Di Stefano; Martin Möschel; Nikolaus Hübl; Ingmar Königsrainer Journal: Thorac Cancer Date: 2021-08-17 Impact factor: 3.500
Authors: Saad Habib; Nicholas Fuca; Mohammed Azam; Abdul Hasan Siddiqui; Kartikeya Rajdev; Michel Chalhoub Journal: Respir Med Case Rep Date: 2018-10-16