Factors predictive of the failure of medical treatment in patients with pleural infection.
10.3904/kjim.2014.29.5.603
- Author:
Sung Kyoung KIM
1
;
Chul Ung KANG
;
So Hyang SONG
;
Deog Gon CHO
;
Kyu Do CHO
;
Chi Hong KIM
Author Information
1. Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. chihongk@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Empyema, pleural;
Drainage;
Fibrinolytic agents;
Treatment outcome
- MeSH:
Adult;
Aged;
Anti-Bacterial Agents/therapeutic use;
Cohort Studies;
Drainage;
Empyema, Pleural/metabolism/*therapy;
Female;
Glucose/metabolism;
Humans;
L-Lactate Dehydrogenase/metabolism;
Male;
Pleural Effusion/metabolism/*therapy;
Serum Albumin/metabolism;
Thoracic Surgery, Video-Assisted;
Treatment Failure
- From:The Korean Journal of Internal Medicine
2014;29(5):603-612
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The clinical outcomes of some patients with pleural infection may be favorable with medical treatment alone, but in others, the disease progresses and requires additional surgical treatment. However, little is known about the factors affecting this difference. The aim of this study was to investigate the factors predictive of failure of medical treatment in patients with pleural infection. METHODS: A cohort of 127 consecutive patients who were admitted to the hospital with pleural infection was studied. Clinical manifestations and laboratory findings in patients in whom medical treatment succeeded or failed were reviewed. RESULTS: In univariate analysis, the significant factors associated with medical treatment outcome were age, smoking history, duration of chief complaint, serum albumin level, and pleural fluid glucose and lactate dehydrogenase levels (p < 0.05). Multivariate logistic regression analysis identified age and duration of chief complaint as independent predictive factors for failure of medical treatment, with odds ratios of 0.871 (p = 0.013) and 0.797 (p = 0.026), respectively. Receiver operating characteristic curve analysis determined cutoff values of 50.5 years for age and 4.5 days for duration of chief complaint. CONCLUSIONS: We demonstrated that a younger age < 50.5 years and shorter duration of chief complaint < 4.5 days were independent predictive factors for the failure of medical treatment in patients with pleural infection. This suggests their role as evaluative criteria in setting indications for the optimal treatment in patients with pleural infection. A larger, prospective study is required to confirm these findings.
