Clinical Features, Management and Outcomes of Pediatric Pleural Empyema: A Retrospective, Multicenter Cross Sectional Study

Objectives: To evaluate clinical features, treatment strategies, and outcomes of pleural empyema for children who were treated at referral pediatric hospitals in 8 provinces of Iran. Methods: In this retrospective, multicenter cross sectional study, we retrospectively retrieved patients’ data from 8 teaching hospitals during 2010 and 2017. A questionnaire was applied and filled, and all data were statistically and descriptively analyzed. Results: In total, 191 children (109 males and 82 females) were included. Their mean age was 4.95 years and ranged from 11 months to 16 years. The majority of cases (45.1%) were 1-4 years old. Fever (70.3%), cough (65.6%), tachypnea (53.1%), chest pain (14.6%), and abdominal pain (12%) were the most common manifestations at admission. The mean length of admission in hospital was 16.4 d. Consequently, 27 patients (14.1%) were admitted into the pediatric intensive unit because of severe illness, and 15 patients (7.9%) died. Logistic regression analysis showed that younger age (less than 12 months) and presence of underlying diseases (such as cardiovascular disease, immune deficiencies, malignancies, and neuro-developmental delay) significantly increased the mortality rate of patients with pleural empyema (P=0.004 and P=0.001, respectively). Conclusions: Pleural empyema children of younger age and with underlying diseases are at higher risks of death. In addition, guidelines for treating pleural empyema should be developed.