Parapneumonic Effusion and Thoracic Empyema in Adults. Clinical Aspects, Microbiology and Frequency of Surgical Outcome.

BACKGROUND:To date, information about the outcome of patients with parapneumonic effusion and empyema is limited.OBJECTIVE:To describe the clinical characteristics, the microbiological study and the frequency and type of surgical treatment in adult patients with parapneumonic effusion or empyema.METHOD:A prospective cross-sectional study of patients admitted with parapneumonic effusion or empyema, from August 2011 to July 2014, in a reference hospital for respiratory diseases in Mexico City, was conducted. Clinical characteristics, microbiology, risk categories for poor prognosis in empyema and frequency and type of surgical treatment were studied.RESULTS:We studied 284 patients whose median age was 47 years, 75% were men, and 57.7% were transferred from other hospitals. In 38.5% of the cases a microorganism was identified and there was a predominance of Gram negative. 153 (53.9%) required surgical treatment, of which 90% were thoracotomy with decortication. Hospital mortality was 5.63%.CONCLUSIONS:Most of the patients arrived in advanced stages of the disease, so more than half required surgery, of which 90% was decortication. It is desirable to favor mechanisms for early diagnosis and treatment to reduce the need for surgical treatment.