Surgical management of pleural empyema in the very elderly
| Autor: | Michael Schweigert, M Beron, Norbert Solymosi, D Oefner-Velano, L Thumfart, Attila Dubecz, Hubert J. Stein |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cardiothoracic Surgery medicine.medical_specialty Adolescent Tertiary referral hospital Sepsis Young Adult Bronchoscopy medicine Humans Risk factor Young adult Empyema Pleural Aged Aged 80 and over Postoperative Care medicine.diagnostic_test Thoracic Surgery Video-Assisted business.industry Pleural empyema Mortality rate Pneumonia General Medicine Middle Aged medicine.disease respiratory tract diseases Surgery Treatment Outcome Debridement Female business Very elderly patients |
| Zdroj: | Annals of The Royal College of Surgeons of England |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/003588412x13171221592212 |
| Popis: | INTRODUCTION Parapneumonic pleural empyema is a critical illness. Age is an acknowledged risk factor for both pneumonia and pleural empyema. Furthermore, elderly patients often have severe co-morbidity. In the case of pleural empyema, their clinical condition is likely to deteriorate fast, resulting in life threatening septic disease. To prevent this disastrous situation we adapted early surgical debridement as the primary treatment option even in very elderly patients. This study shows the outcome of surgically managed patients with pleural empyema who are 80 years or older. METHODS The outcomes of 222 consecutive patients who received surgical therapy for parapneumonic pleural empyema at a German tertiary referral hospital between 2006 and 2010 were reviewed in a retrospective case study. Patients older than 80 years were identified. RESULTS There were 159 male and 63 female patients. The mean age was 60.5 years and the overall in-hospital mortality rate was 7%. Of the 222 patients, 37 were 80 years or older (range: 80–95 years). The frequencies of predominantly cardiac co-morbidity and high ASA (American Society of Anesthesiologists) grades were significantly higher for very elderly patients (pCONCLUSIONS Early surgical treatment of parapneumonic pleural empyema shows excellent results even in very elderly patients. Despite considerable co-morbidity and often delayed diagnosis, minimally invasive surgery was feasible in 34 patients (92%). The in-hospital mortality of very elderly patients was low. It can therefore be concluded that advanced age is no contraindication for early surgical therapy. |
| Databáze: | OpenAIRE |
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