Complicated Pleural Infection is Associated With Prolonged Recovery and Reduced Functional Ability.

Autor:	Meggyesy AM; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA., Wilshire CL; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA., Bograd AJ; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA., Chiu ST; Medical Data Research Center, Providence Health and Services, Portland, OR., Gilbert CR; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA., Rahman NM; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK., Bedawi EO; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK., Vallieres E; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA., Gorden JA; Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA.
Jazyk:	angličtina
Zdroj:	Journal of bronchology & interventional pulmonology [J Bronchology Interv Pulmonol] 2024 Jul 22; Vol. 31 (4). Date of Electronic Publication: 2024 Jul 22 (Print Publication: 2024).
DOI:	10.1097/LBR.0000000000000974
Abstrakt:	Background: Management of complicated pleural infections (CPIs) had historically been surgical; however, following the publication of the second multicenter intrapleural sepsis trial (MIST-2), combination tissue plasminogen (tPA) and dornase (DNase) offers a less invasive and effective treatment. Our aim was to assess the quality of life (QOL) and functional ability of patients' recovery from a CPI managed with either intrapleural fibrinolytic therapy (IPFT) or surgery. Methods: We identified 565 patients managed for a CPI between January 1, 2013 and March 31, 2018. There were 460 patients eligible for contact, attempted through 2 phone calls and one mailer. Two questionnaires were administered: the Short Form 36-Item Health Survey (SF-36) and a functional ability questionnaire. Results: Contact was made in 35% (159/460) of patients, and 57% (90/159) completed the survey. Patients had lower QOL scores compared to average US citizens; those managed with surgery had higher scores in physical functioning (surgery: 80, IPFT: 70, P=0.040) but lower pain scores (surgery: 58, IPFT: 68, P=0.045). Of 52 patients who returned to work, 48% (25) reported an impact on their work effectiveness during recovery, similarly between management strategies (IPFT: 50%, 13/26 vs. surgery: 46%, 12/26; P=0.781). Conclusion: Patients with a CPI had a lower QOL compared with average US citizens. Surgically managed patients reported improved physical functioning but worse pain compared with patients managed with IPFT. Patients returned to work within 4 weeks of discharge, and nearly half reported their ability to work effectively was impacted by their recovery. With further research into recovery timelines, patients may be appropriately counselled for expectations. Competing Interests: Disclosure: There is no conflict of interest or other disclosures. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu