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Arch Pediatr Adolesc Med. 2012 Nov;166(11):999-1004. doi: 10.1001/archpediatrics.2012.1055.

The long-term outcomes of pediatric pleural empyema: a prospective study.

Author information

1
Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada. eyal.cohen@sickkids.ca

Abstract

OBJECTIVE:

To describe the long-term outcomes of pediatric pleural empyema.

DESIGN:

Prospective observational study from October 2008 to October 2011.

SETTING:

Tertiary care children's hospital.

PARTICIPANTS:

Children with pleural empyema (loculations and/or septations identified on radiologic imaging or frank pus on thoracentesis).

MAIN OUTCOME MEASURES:

Children were seen 1, 6, and 12 months postdischarge. Outcome measures included symptoms and signs of respiratory disease, child and parental impact, radiographic resolution, spirometry, and health-related quality of life (Pediatric Quality of Life Inventory score). Analysis was based on the last observation carried forward for missing data.

RESULTS:

Eighty-two of 88 patients (93%) eligible were recruited. Fifty-four percent were male and mean (SD) age was 4.5 (3.4) years. Outcome data was obtained in 100% at 1 month, 90% at 6 months, and 72% at 1 year. Seventy-one percent had effusions occupying a quarter or more of the hemithorax and 62% of effusions were drained. Fever, cough, parental work loss, child school loss, radiographic abnormalities, and abnormal spirometry results were common in the first month and then declined. By the last observation, 2% of patients had abnormal radiographs (aside from pleural thickening), 6% had mild obstruction on spirometry, and Pediatric Quality of Life Inventory scores were better than for children with asthma (P < .001). Patients with abnormal outcomes in 1 measure had normal outcomes in all other clinical measures.

CONCLUSIONS:

Clinically important phenomena persist in the short-term, but virtually all children with pleural empyema have no long-term sequelae.

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[Indexed for MEDLINE]

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