%0 Journal Article
%T Empiema paraneum¨®nico: caracterizaci¨®n y factores asociados a morbi-mortalidad en 242 casos tratados quir¨²rgicamente Parapneuminic empyema: characterization and factors associated with morbility and mortality in 242 surgical cases
%A Roberto Gonz¨¢lez L
%A Rafael Prats M
%A David Lazo P
%A Andr¨¦s Jadue T
%J Revista Chilena de Enfermedades Respiratorias
%D 2012
%I Sociedad Chilena de Enfermedades Respiratorias
%X Objetivos: Describir las caracter¨ªsticas y evaluar los factores asociados a morbi-mortalidad en el empiema paraneum¨®nico (EPN) tratado quir¨²rgicamente. M¨¦todo: Revisi¨®n retrospectiva entre Enero 2000 y Agosto 2006. Se describen caracter¨ªsticas y factores asociados a morbi-mortalidad, se realiz¨® an¨¢lisis univariado y multivariado utilizando programa SPSS 15.0. Resultados: 242 pacientes ten¨ªan EPN (70,6% de los empiemas tratados), 165 (68,2%) fueron hombres, edad promedio 52,1 a os, 229 (94,6%) fueron neumon¨ªas adquiridas en la comunidad (NAC) y 13 (5,4%) intrahospitalarias. Se aisl¨® g¨¦rmenes en l¨ªquido pleural en 57 (23,6%). Se realizaron 183 (75,6%) decorticaciones, 49 (20,2%) pleurotom¨ªas, 7 (2,9%), cirug¨ªas video-asistidas y 3 (1,2%) decorticaciones con resecci¨®n pulmonar. Presentaron complicaciones 65 (26,9%). Fallecieron 16 pacientes (6,6%). Se identificaron variables asociadas a morbi-mortalidad. Conclusiones: El EPN es la causa m¨¢s frecuente de empiema, la mayor¨ªa est¨¢ asociado a NAC y en pocos se identifican g¨¦rmenes. La decorticaci¨®n es el procedimiento m¨¢s frecuente. Se identificaron las variables asociadas a morbi-mortalidad en esta serie cl¨ªnica. Objectives: To describe and evaluate factors associated with morbidity and mortality in surgically treated parapneumonic empyemas (PNE). Method: Retrospective review between January 2000 and August 2006. We described clinical features and we performed univariate and multivariate analysis to find the factors associated with morbidity and mortality. SPSS 15.0 program was used in the statistical analysis. Results: 242 of343 surgically treated empyemas (70.6%) were paraneumonic. Of these 165 (68.2%) were men, average age 52.1 years, 229 (94.6%) were community-acquired pneumonia (CAP) and 13 (5.4%) nosocomial. Germs were isolated in pleural fluid in 57 (23.6%). Surgical procedures were: 183 (75.6%) decortications, 49 (20.2%) pleurotomies, 7 (2.9%) video-assisted surgery and 3 (1.2%) decortications with pulmonary resection. Complications occurred in 65 cases (26.9%) and 16 patients died (6.6%). We found variables associated with morbidity and mortality. Conclusions: PNE is the most common cause of empyema, mostly associated with CAP and germs are difficult to identify. Decortication is the most common surgical treatment. Morbidity and mortality are present. Variables associated with morbidity and mortality were identified in this clinical series.
%K Empiema pleural
%K patolog¨ªa pleural
%K neumon¨ªa
%K cirug¨ªa tor¨¢cica
%K morbilidad
%K mortalidad
%K Empyema
%K pleural diseases
%K pneumonia
%K thoracic surgical procedures
%K morbidity
%K mortality
%U http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-73482012000100003