The risk factors and management of posttraumatic empyema in trauma patients

Eren, Şevval; Eşme, Hıdır; Şehitoğulları, Abidin; Durkan, Atilla

doi:10.1016/j.injury.2007.06.001

Cited by 85 publications

(64 citation statements)

References 23 publications

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“…Twenty-four patients had intrathoracic infectious pleuropulmonary complications resulting from RH -empyema, pneumonia and infected lung injury. Previous studies indicate incidences ranging from 3% to 27% for these complicações 11,14,23,24 . In this work the incidence was 32.8%, 16.4%, and 4.9% for empyema, pneumonia and infected pulmonary contusion, respectively.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Associated factors to empyema in post-traumatic hemotorax

Neto

Resende

Machado

et al. 2015

Rev. Col. Bras. Cir.

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Objective:to analyze the associated factors with empyema in patients with post-traumatic retained hemothorax.Methods:prospective observational study. Data were collected in patients undergoing PD during emergency duty. Variables analyzed were age, sex, mechanism of injury, side of the chest injury, intrathoracic complications of RH, laparotomy, specific injuries, rib fractures, trauma scores, days to diagnosis, diagnostic method of RH, primary indication of PD, initial volume drained, length of the first tube removal, surgical procedure. Cumulative incidence of empyema, pneumonia and pulmonary contusion and the proportion of patients with empyema or without empyema in each category of each variable analyzed were obtained.Results: the cumulative incidence of PD among trauma patients was 1.83% and the RH among those with PD was 10.63%. There were 20 cases of empyema (32.8%). Most were male in the age from 20 to 29, victims of injury by firearm on the left side of the thorax. The incidence of empyema in patients with injury by firearms was lower compared to those with stab wound or blunt trauma; higher among those with drained volume between 300 and 599 ml. The median hospital lenght of stay was higher among those with empyema.Conclusion:the incidence of PD was 1.83% and RH was 10.63%, these results are consistent with the low severity of the patients involved in this study and consistent with the literature. The incidence of empyema proved to be negatively associated with the occurrence of injury by firearms and positively associated with a drained volume between 300 and 599 ml, compared with lower or higher volumes.

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Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Associated factors to empyema in post-traumatic hemotorax

Neto

Resende

Machado

et al. 2015

Rev. Col. Bras. Cir.

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“…23 Physicians' practice is highly heterogeneous in the management of minor thoracic injury, with or without rib fractures, especially in terms of discharge follow-up plans and admission. 21 Because hemothorax is associated with important consequences, such as acute respiratory distress syndrome, emphysema, functional limitations, infections and longer lengths of stay in hospital, 20,[37][38][39][40][41] post-emergency planning creates challenges for both health care professionals and patients. It is impossible to follow all patients with minor thoracic injury in overcrowded emergency departments.…”

Section: Discussionmentioning

confidence: 99%

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study

et al. 2017

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“…Chest tubes could prevent pleural effusion and life-threatening tension pneumothorax, measure the blood loss and air leakage (11). However, chest tubes are associated with postoperative pain, functional limitation (1), risk of infection (12) and hinder pulmonary mechanics (13). The timing of tube removal is limited by several reasons, of which postoperative drainage volume might be the major rate-limiting factor.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal micro-vessels clipping during lymph node dissection may contribute to reduce postoperative pleural drainage

Yan¹,

Wang²,

Lv³

et al. 2016

J. Thorac. Dis.

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Background: Postoperative pleural drainage markedly influences the length of postoperative stay and financial costs of medical care. The aim of this study is to retrospectively investigate potentially predisposing factors related to pleural drainage after curative thoracic surgery and to explore the impact of mediastinal micro-vessels clipping on pleural drainage control after lymph node dissection. were assessed using multivariable logistic regression analysis.Results: Propensity score matching resulted in 197 patients (matched cohort). Baseline patient characteristics were matched between two groups. Group clip showed less cumulative drainage volume (P=0.020), shorter duration of chest tube (P=0.031) and postoperative hospital stay (P=0.022) compared with group control. Risk factors significantly associated with high-output drainage in multivariable logistic regression analysis were being male, age >60 years, bilobectomy/sleeve lobectomy, pleural adhesion, the application of clip applier, duration of operation ≥220 minutes and chylothorax (P<0.05).Conclusions: This study suggests that mediastinal micro-vessels clipping during lymph node dissection may reduce postoperative pleural drainage and thus shorten hospital stay.

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The risk factors and management of posttraumatic empyema in trauma patients

Cited by 85 publications

References 23 publications

Associated factors to empyema in post-traumatic hemotorax

Associated factors to empyema in post-traumatic hemotorax

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study

Mediastinal micro-vessels clipping during lymph node dissection may contribute to reduce postoperative pleural drainage

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