Mwesige Michael, Otim Paul, Iranya Richard N, Magala John Paul, Makumbi Timothy K
Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Surgery, Soroti University, Soroti, Uganda.
BMC Pulm Med. 2025 Aug 1;25(1):365. doi: 10.1186/s12890-025-03861-0.
Empyema thoracis is a debilitating illness observed in all age groups. Recent data indicate increasing incidence rates and worsening outcomes. However, published data on the outcomes of empyema thoracis cases in our setting are scarce.
This study evaluated outcomes and associated factors for adult empyema thoracis patients managed at a single tertiary center in Uganda.
We reviewed the file records of patients 18 years or older who were managed for empyema thoracis at Mulago National Referral Hospital from January 2017 to December 2021. Sociodemographic data, comorbidities, clinical parameters at admission, and management strategies were reviewed. The outcomes of interest were in-hospital mortality and the need for re-intervention. A multivariate logistic regression model was used to identify independent factors associated with the need for re-intervention and in-hospital mortality.
A total of 200 case files were analyzed, and 123 (61.5%) of the cases were males. The median age of the cohort was 33 years (IQR = 21). The in-hospital mortality rate was 10.5% (21 patients), and 23.5% (47 patients) required one or more re-interventions. Advancing age (adjusted OR = 1.04 (1.01-1.08)) and non para-pneumonic underlying etiology (adjusted OR = 11.45 (2.74-47.89)) were independently associated with increased in-hospital mortality, whereas delayed empyema drainage (adjusted OR = 2.97 (1.33-6.67)) and underlying non para-pneumonic etiology (adjusted OR = 3.83 (1.45-10.10.10)) significantly increased the odds of the need for re-intervention in management.
The in-hospital mortality and re-intervention rates for empyema thoracis were high in our study. Particularly at-risk groups for these poor outcomes are those with advanced age, non para-pneumonic empyema thoraces, and delayed initial intervention.
脓胸是一种在各年龄组中均有发现的使人衰弱的疾病。近期数据表明其发病率在上升，且预后在恶化。然而，关于我们所在地区脓胸病例预后的已发表数据很少。
本研究评估了在乌干达一家单一的三级中心接受治疗的成年脓胸患者的预后及相关因素。
我们回顾了2017年1月至2021年12月在穆拉戈国家转诊医院接受脓胸治疗的18岁及以上患者的病历记录。审查了社会人口统计学数据、合并症、入院时的临床参数和管理策略。感兴趣的结局是住院死亡率和再次干预的必要性。使用多因素逻辑回归模型来确定与再次干预需求和住院死亡率相关的独立因素。
共分析了200份病例档案，其中123例（61.5%）为男性。该队列的中位年龄为33岁（四分位间距=21）。住院死亡率为10.5%（21例患者），23.5%（47例患者）需要进行一次或多次再次干预。年龄增长（调整后的比值比=1.04（1.01-1.08））和非肺炎旁源性基础病因（调整后的比值比=11.45（2.74-47.89））与住院死亡率增加独立相关，而脓胸引流延迟（调整后的比值比=2.97（1.33-6.67））和基础非肺炎旁源性病因（调整后的比值比=3.83（1.45-10.10.10））显著增加了管理中再次干预需求的几率。
在我们的研究中，脓胸的住院死亡率和再次干预率很高。这些不良结局的特别高危人群是年龄较大、非肺炎旁源性脓胸和初始干预延迟的患者。
