Multimodal treatment for acute empyema based on the patient’s condition, including patients who are bedridden: A single center retrospective study
| Autor: | Jun Kawachi, Yuto Igarashi, Toshitaka Tsukiyama, Naoko Isogai, Takaaki Murata, Katsunori Miyake, Tomoki Nishida, Yuma Suno, Rai Shimoyama, Hiroyuki Kashiwagi, Ryuta Fukai |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty acute empyema Percutaneous Acute empyema Performance status business.industry Incidence (epidemiology) Retrospective cohort study CT-guided drainage Pleural cavity Single Center Health Professions (miscellaneous) elderly patient Surgery medicine.anatomical_structure medicine Fibrinolytic therapy fibrinolytic therapy business Research Article |
| Zdroj: | Canadian Journal of Respiratory Therapy: CJRT = Revue Canadienne de la Thérapie Respiratoire : RCTR |
| ISSN: | 2368-6820 |
| DOI: | 10.29390/cjrt-2021-032 |
| Popis: | Background The incidence of acute empyema has increased in various countries; some elderly patients with acute empyema have contraindications for surgery under general anesthesia. Therefore, suitable management based on a patient’s clinical condition is required. Methods We evaluated the different surgical and nonsurgical therapeutic approaches available for patients with acute empyema. This was a retrospective study of 57 patients with acute empyema who received treatment in our department between May 2015 and February 2019. For patients who did not initially improve with drainage or drainage combined with fibrinolytic therapy, surgery, or additional percutaneous drainage was performed based on their general condition. We compared several clinical factors pertaining to the patients who underwent surgical versus nonsurgical treatment. Results Our study showed that the patients with a performance status of 0–2 and an American Society of Anesthesiologists physical status classification of class II or lower underwent surgery safely without major operative complications. The combination of repeated drainage of the pleural cavity and fibrinolytic therapy appeared to be a reasonable nonsurgical management option for patients in poor overall condition. Conclusion For an aging population, we think that the combination of repeated pleural cavity drainage procedures and fibrinolytic therapy is a reasonable nonsurgical strategy for the management of patients with acute empyema. |
| Databáze: | OpenAIRE |
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