| Autor: |
Sacco Casamassima, Maria Grazia, Noel-MacDonnell, Janelle R., Oyetunji, Tolulope A., St. Peter, Shawn D. |
| Předmět: |
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| Zdroj: |
Pediatric Surgery International; 11/4/2024, Vol. 40 Issue 1, p1-10, 10p |
| Abstrakt: |
Background: This study seeks to investigate the contemporary use and effectiveness of fibrinolysis as a first-line option in pediatric empyema. Methods: The Pediatric Health Information System (PHIS) was queried to identify patients with empyema without fistula (2018–2023). First-line treatments were chest drainage (CD), chest drainage with fibrinolysis (CDF), and video-assisted thoracoscopic surgery/open decortication (VATS/OD). Outcomes between groups were compared using Kruskal–Wallis and Chi-Square tests. Multivariate generalized linear model was used to account for covariates. Results: 581 individuals/cases met inclusion criteria. CD accounted for 11.9% of cases, CDF for 67.6%, and VATS/OD for 20.7%. After adjusting for covariates differences in LOS were not significant (p = 0.393). Subsequent VATS/ODs were required in 6.9% of CDF cases, 8.9% of CD, and 3.3% of primary VATS/OD. Additionally, 32.5% of primary VATS/OD received adjuvant fibrinolysis. Complications were more often observed in the VATS/OD group compared to CD and CDF (11.7% vs 5.8% and 4.1% respectively; p =.008). There were no differences in 30-day readmission rate (VATS/OD:1.2%, CTD:1.5%, and CTDF:1%; p = 0.83). Conclusion: Fibrinolysis is now utilized as first-line treatment for most patients and as adjunct in other approaches. The findings justify further implementation as it is the less invasive first-line primary therapy in patients with empyema. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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