Empiema paraneumónico: caracterización y factores asociados a morbi-mortalidad en 242 casos tratados quirúrgicamente

Objectives: To describe and evaluate factors associated with morbidity and mortality in surgically treated parapneumonic empyemas (PNE). Method: Retrospective review between January 2000 and August 2006. We described clinical features and we performed univariate and multivariate analysis to find the factors associated with morbidity and mortality. SPSS 15.0 program was used in the statistical analysis. Results: 242 of343 surgically treated empyemas (70.6%) were paraneumonic. Of these 165 (68.2%) were men, average age 52.1 years, 229 (94.6%) were community-acquired pneumonia (CAP) and 13 (5.4%) nosocomial. Germs were isolated in pleural fluid in 57 (23.6%). Surgical procedures were: 183 (75.6%) decortications, 49 (20.2%) pleurotomies, 7 (2.9%) video-assisted surgery and 3 (1.2%) decortications with pulmonary resection. Complications occurred in 65 cases (26.9%) and 16 patients died (6.6%). We found variables associated with morbidity and mortality. Conclusions: PNE is the most common cause of empyema, mostly associated with CAP and germs are difficult to identify. Decortication is the most common surgical treatment. Morbidity and mortality are present. Variables associated with morbidity and mortality were identified in this clinical series.