Risk factors related to pleural empyema after talc slurry pleurodesis.
Empyema
Malignancy
Pleural Effusion
Pleurodesis
Journal
Clinics (Sao Paulo, Brazil)
ISSN: 1980-5322
Titre abrégé: Clinics (Sao Paulo)
Pays: United States
ID NLM: 101244734
Informations de publication
Date de publication:
2022
2022
Historique:
received:
02
04
2022
revised:
29
06
2022
accepted:
03
08
2022
entrez:
30
8
2022
pubmed:
31
8
2022
medline:
3
9
2022
Statut:
epublish
Résumé
Empyema is a complication of talc-pleurodesis that may lead to further surgical intervention and death. Therefore, the present study's objective was to identify the risk factors for the development of post-pleurodesis empyema after talc slurry pleurodesis in order to better select patients for this procedure and minimize its morbidity. Patients with malignant pleural effusion who underwent talc slurry pleurodesis at the present institution from January 2018 to January 2020 were retrospectively analyzed. Post-pleurodesis empyema was defined as pleural infection up to 30 days after pleurodesis. Using Cox regression analysis, significant prognostic factors for the development of empyema were examined. Of the 86 patients identified for inclusion in the study, 62 were women (72%). Their mean age was 56.3±12.6 years. The median pleural drainage time was 9 days, and 20 patients (23.3%) developed empyema. In the univariate analysis, both drainage time (p = 0.038) and the use of antibiotics prior to pleurodesis (p < 0.001) were risk factors for pleural empyema. Multivariate analysis also identified the use of antibiotics as an independent risk factor (Odds Ratio [OR] 9.81; 95% Confidence Interval [95% CI] 2.87‒33.54). Although the pulmonary expansion was not associated with empyema in the multivariate analysis, patients with less than 50% pulmonary expansion had a 4.5-times increased risk of empyema (95% CI 0.90‒22.86; p = 0.067), and patients with 50‒70% pulmonary expansion had a 3.8-times increased risk of empyema (95% CI 0.98‒15; p = 0.053) after pleurodesis. The study suggests that antibiotic therapy prior to talc slurry pleurodesis may increase the risk of developing empyema. Furthermore, pleurodesis should be considered with caution in patients with long-duration chest tube placement and incomplete lung expansion.
Identifiants
pubmed: 36041370
pii: S1807-5932(22)03299-9
doi: 10.1016/j.clinsp.2022.100098
pmc: PMC9440271
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Talc
14807-96-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
100098Informations de copyright
Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest The authors declare no conflicts of interest.
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