Chu Pei-Yi, Wu Yu-Cheng, Lin Ya-Ling, Chang Hung, Lee Shih-Chun, Huang Tsai-Wang, Tsai Yuan-Ming
Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 1140, Taiwan.
Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
J Pers Med. 2022 Jun 20;12(6):1014. doi: 10.3390/jpm12061014.
Empyema is a major cause of mortality and hospitalization. Symptoms include difficulty breathing and chest pain. Calcium plays an essential role in the physiology of the cardiovascular system. However, there is little evidence on the role of echocardiography and the serum calcium levels of patients undergoing video-assisted thoracoscopic surgery (VATS) for empyema. This study aimed to investigate the risk factors for postoperative mortality in patients with empyema who required surgery.
This single-institution retrospective study compared the outcomes of VATS for thoracic empyema (in terms of survival and mortality) in 122 patients enrolled between July 2015 and June 2019.
This study examined patients with thoracic empyema. The majority of the patients were males (100/122, 81.9%). The in-hospital/30-day mortality rate was 10.6% (13 patients). The calcium levels were 7.82 ± 1.17 mg/dL in the survival group and 6.88 ± 1.88 mg/dL in the mortality group ( = 0.032). In the mortality group, the utilization of echocardiography and serum calcium levels independently contributed to the risk prediction more than clinical variables. Patients in our cohort exhibited elevated pulmonary artery systolic pressure (PASP) and hypocalcemia, which were associated with increased postoperative mortality.
Elevated PASP and calcium levels at the low end of the normal range demonstrated significant prognostic value in predicting mortality in patients with thoracic empyema who required surgical intervention. Recognizing this potential is critical in order to obtain better outcomes.
脓胸是导致死亡和住院的主要原因。症状包括呼吸困难和胸痛。钙在心血管系统生理过程中起着至关重要的作用。然而，关于脓胸患者接受电视辅助胸腔镜手术（VATS）时超声心动图的作用及血清钙水平的证据很少。本研究旨在调查需要手术的脓胸患者术后死亡的危险因素。
这项单机构回顾性研究比较了2015年7月至2019年6月期间纳入的122例接受VATS治疗胸腔脓胸患者的结局（生存率和死亡率）。
本研究对胸腔脓胸患者进行了检查。大多数患者为男性（100/122，81.9%）。住院/30天死亡率为10.6%（13例患者）。生存组的钙水平为7.82±1.17mg/dL，死亡组为6.88±1.88mg/dL（P = 0.032）。在死亡组中，超声心动图的应用和血清钙水平比临床变量更能独立地对风险预测产生影响。我们队列中的患者表现出肺动脉收缩压（PASP）升高和低钙血症，这与术后死亡率增加相关。
PASP升高和正常范围下限的钙水平在预测需要手术干预的胸腔脓胸患者死亡率方面具有显著的预后价值。认识到这一潜力对于获得更好的结局至关重要。
