Department of Cardio-Thoracic Surgery, Tampere University Heart Hospital, Tampere, Finland.
Department of Radiology, Tampere University Hospital, Tampere, Finland.
Scand J Surg. 2020 Jun;109(2):127-132. doi: 10.1177/1457496919832146. Epub 2019 Feb 21.
The aim of the study was to ascertain changes in the incidence, etiology, treatment, and outcomes of pleural infections over a decade in a Finnish University Hospital.
All patients treated for pleural infections in Tampere University Hospital during 2000-2008 and 2012-2016 were included. The incidence rates and the epidemiologic data and medical history of patients, etiology of infection, and treatment trends and outcomes were compared between the cohorts.
The incidence of pleural infections increased from 4.4 during 2000-2008 to 9.9 during 2012-2016 per 100.000 patient-years, p < 0.001. The patients in the latter group were older, 63 versus 57 years, p = 0.001, and the prevalence of chronic lung disease, hypertension, heart failure, dyslipidemia, and immunosuppressive medication were higher. The causes of infection remained similar and pneumonia accounted for 70% of all cases. The identification rate of the microbe pathogens increased from 49% to 64%, p = 0.002, while the distribution of identified pathogens was unchanged. More patients in the latter cohort were treated operatively, 88.3% versus 80.9%, p = 0.005, and, in these, the proportion of thoracoscopic surgery was higher, 57.4% versus 8.0%, p < 0.001, and the delay to surgery shorter, 5 versus 7 days, p < 0.001. Radiologic outcomes were similar. The 30-day mortality rate was 3.1% during 2000-2008 and 5.1% during 2012-2016, p = 0.293.
The overall incidence of pleural infections has increased significantly while the causes of pleural infections and the distribution of pathogens remain unchanged. Contemporary patients are older with higher prevalence of comorbidities and more frequently undergo thoracoscopic surgery.
本研究旨在确定在芬兰一所大学医院，胸膜感染的发病率、病因、治疗方法和结果在十年间的变化。
纳入 2000-2008 年和 2012-2016 年期间在坦佩雷大学医院接受胸膜感染治疗的所有患者。比较两组患者的发病率和流行病学数据及病史、感染病因、治疗趋势和结果。
胸膜感染的发病率从 2000-2008 年的每 100000 患者年 4.4 例增加到 2012-2016 年的 9.9 例，p<0.001。后者组患者年龄更大，分别为 63 岁和 57 岁，p=0.001，且慢性肺部疾病、高血压、心力衰竭、血脂异常和免疫抑制药物的患病率更高。感染的原因仍相似，肺炎占所有病例的 70%。微生物病原体的检出率从 49%增加到 64%，p=0.002，而鉴定病原体的分布保持不变。后者组更多的患者接受了手术治疗，分别为 88.3%和 80.9%，p=0.005，其中胸腔镜手术的比例更高，分别为 57.4%和 8.0%，p<0.001，手术时间更短，分别为 5 天和 7 天，p<0.001。影像学结果相似。2000-2008 年 30 天死亡率为 3.1%，2012-2016 年为 5.1%，p=0.293。
胸膜感染的总体发病率显著增加，而胸膜感染的病因和病原体分布保持不变。当代患者年龄更大，合并症患病率更高，更常接受胸腔镜手术。
