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Video assisted thoracoscopic surgery effective treatment for empyema
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Most children with empyema can be treated with chest tube drainage, according to recent study findings published in The Pediatric Infectious Disease Journal.
Michelle M. Kelly, MD, of the department of pediatrics at the University of Wisconsin School of Medicine and Public Health, and colleagues evaluated hospital stays in children aged 0 to 18 years from 1997 to 2009 to determine transfer-out rates and lengths of stay across various types of treatment.
Empyema discharges that were coded for two or more pleural drainage procedures increased from 36.9% in 1997 to 41.5% in 2009 (P<.01); however, those not coded for a major drainage procedure decreased from 23.6% in 1997 to 17.8% in 2009 (P<.01). During the study period, mean length of stay also declined from 15.1 days to 13.8 days, according to the study data.
Nearly 53% of drainage procedures were video-assisted thoracoscopic surgery, followed by chest tube (45.4%) and open thoracotomy (18.5%).
“In conclusion, this population-based analysis demonstrates a strong (and increasing) tendency toward procedural management in hospital stays in children with empyema in the US,” the researchers wrote. “[Video-assisted thoracoscopic surgery] became the most commonly performed drainage procedure during 2009, and discharges coded for [video-assisted thoracoscopic surgery] are associated with lower transfer-out rates but no statistically significant reduction in [length of stay] after accounting for patient and hospital factors. Results of our population-based study are consistent with recently published practice guidelines and recommendations that endorse chest tube drainage as an acceptable first treatment option for most children with empyema.”
Disclosure: The researchers report no relevant financial disclosures.
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