Journal article
Prognostic Value of Computed Tomography in Empyema: A Multicenter Retrospective Cohort Study
Annals of the American Thoracic Society, Vol.20(6), pp.807-814
06/2023
DOI: 10.1513/AnnalsATS.202210-868OC
PMID: 37166901
Abstract
Rationale: Chest computed tomography is performed in patients with empyema for various reasons. However, its predictive ability for patient outcomes in empyema has not been evaluated. Objective: To evaluate the predictive ability of computed tomography findings (pleural thickness, loculation, interlobar pleural effusion, lung abscess, and bronchopleural fistula) for 90-day mortality in empyema. Methods: This multicenter retrospective cohort study was conducted across six acute care hospitals in Japan. We included patients with a confirmed empyema diagnosis who underwent chest computed tomography within 7 days of diagnosis. Imaging findings were defined as pleural thickness, loculation, interlobar pleural effusion, lung abscess, or bronchopleural fistula. One radiologist interpreted the computed tomography scans without patient information. The primary outcome was 90-day mortality. We calculated the differences in the 90-day mortalities between the presence and absence of each computed tomography finding using logistic regression with or without adjustment for early thoracic surgeries. Results: A total of 711 patients were included in our study. Thoracic surgeries were performed in 27% of patients and the 90-day mortality was 10%. The differences in the 90-day mortalities without or with controlling for early thoracic surgeries were as follows: pleural thickness, 3.09% (95% confidence interval: -1.35–7.54%), 2.70% (-1.80% to 7.20%); loculation, -4.01% (-8.61% to 0.60%), -3.80% (-8.41–0.81%); interlobar pleural effusion, -9.15% (-14.58% to -3.72%), -8.96% (-14.39% to -3.53%); lung abscess, 7.04% (-1.16–15.2%), 6.86% (-1.34–15.05%); and bronchopleural fistula, 13.80% (7.66–19.94%), 13.63% (7.50–19.77%), respectively. Conclusion: While interlobar pleural effusion predicted lower 90-day mortality regardless of early thoracic surgery, the presence of bronchopleural fistula predicted higher 90-day mortality with empyema. Our results warrant further validation.
Details
- Title: Subtitle
- Prognostic Value of Computed Tomography in Empyema: A Multicenter Retrospective Cohort Study
- Creators
- Akihiro Shiroshita - Vanderbilt UniversityYuya Kimura - Tokyo National HospitalAtsushi Yamada - Ichinomiya Kenshin CollegeChigusa Shirakawa - Kobe City Medical Center General HospitalCong Yue - Fukushima Medical UniversityHokuto Suzuki - Ichinomiyanishi Hospital, Department of Respiratory Medicine, Ichinomiya, Aichi, JapanKeisuke Anan - Saiseikai Kumamoto HospitalKenya Sato - Saiseikai Yokohamashi Tobu Hospital, 84175, Department of Thoracic Medicine, Yokohama, JapanKiyoshi Nakashima - Ichinomiyanishi Hospital, Department of Respiratory Medicine, Ichinomiya, Aichi, JapanMasafumi Takeshita - Ichinomiyanishi Hospital, Department of Respiratory Medicine, Ichinomiya, Aichi, JapanTakehiro Okuno - Ichinomiyanishi Hospital, Department of Respiratory Medicine, Ichinomiya, Aichi, JapanTatsuya Nitawaki - Saiseikai Kumamoto HospitalHiroyuki Suzuki - University of IowaHiroshi Igei - Tokyo National HospitalJun Suzuki - Saitama Medical UniversityKeisuke Tomii - Kobe City Medical Center General HospitalMasahiro Ohgiya - Tokyo National HospitalYuki Kataoka - Kyoto University
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.20(6), pp.807-814
- DOI
- 10.1513/AnnalsATS.202210-868OC
- PMID
- 37166901
- ISSN
- 2329-6933
- eISSN
- 2325-6621
- Grant note
- name: Ichinomiyanishi Hospital; name: Southern Tohoku Hospital
- Language
- English
- Electronic publication date
- 01/23/2023
- Date published
- 06/2023
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984363272602771
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