KF Lam, LPY Lee, YS Lui, QU Lee, DSY LamKF Lam, LPY Lee, YS Lui, QU Lee, DSY Lam

Abstract

We retrospectively reviewed the records of all patients from 4 months to 18 years old with non-tuberculous parapneumonic effusion and empyema in 4 acute regional hospitals between 2011 and 2021, who underwent chest tube drainage as the first intervention. Of the 156 patients included, 77.6% had a pigtail catheter inserted as the first drainage, and 22.4% had a traditional drain. Thirty-eight (24.4%) required respiratory support other than low-flow oxygen. Thirty-four (27.8%) had thoracic surgery eventually (video-assisted thoracic surgery: 25, thoracotomy: 9). Five (3.2%) required extracorporeal membrane oxygenation. There were 5 cases of mortality (3.2%). Factors independently associated with a favourable clinical course (recovered, no invasive re-intervention, no respiratory support) were higher pleural fluid glucose content, longer duration of fever upon hospital admission, and longer duration between hospital admission and insertion of the first drain. Significant factors independently associated with longer hospitalisation were bacteraemia, pneumothorax, and lower pleural fluid glucose content.