Surgery today · 2026
Clinical outcomes and prognostic factors of open-window thoracostomy for empyema: a retrospective review of 40 patients.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kawakami Toru, Nanami Hayato, Shimoda Kiyomi, Hiramatsu Miyako, Uchimura Kazuhiro, Shiraishi Yuji
Аннотация
PURPOSE: Open-window thoracostomy remains a traditional yet important option for treating empyema. This study aimed to evaluate the clinical outcomes after open-window thoracostomy and identify any prognostic factors based on our institutional experience.
METHODS: We retrospectively reviewed the medical records of 40 consecutive patients who underwent open-window thoracostomy at our institution between January 2010 and December 2020.
RESULTS: The mean age of the patients was 68.3 years, and twenty-five were male. Thirty-five patients had empyema with a fistula and five had empyema without a fistula. The overall survival rates at one, three, and five years were 92.5 percent, 72.9 percent, and 55.9 percent, respectively. A univariate Cox regression analysis followed by a multivariate Cox regression analysis identified three independent prognostic factors for overall survival: preoperative contralateral aspiration pneumonia, prognostic nutritional index < 37.4 (area under the curve 0.742 by receiver operating characteristic analyses), and an elevated white blood cell count.
CONCLUSIONS: The preoperative nutritional status, systemic inflammation, and the presence of contralateral aspiration pneumonia were strongly associated with survival after open-window thoracostomy. This study highlights the importance of these factors in the management of empyema.
METHODS: We retrospectively reviewed the medical records of 40 consecutive patients who underwent open-window thoracostomy at our institution between January 2010 and December 2020.
RESULTS: The mean age of the patients was 68.3 years, and twenty-five were male. Thirty-five patients had empyema with a fistula and five had empyema without a fistula. The overall survival rates at one, three, and five years were 92.5 percent, 72.9 percent, and 55.9 percent, respectively. A univariate Cox regression analysis followed by a multivariate Cox regression analysis identified three independent prognostic factors for overall survival: preoperative contralateral aspiration pneumonia, prognostic nutritional index < 37.4 (area under the curve 0.742 by receiver operating characteristic analyses), and an elevated white blood cell count.
CONCLUSIONS: The preoperative nutritional status, systemic inflammation, and the presence of contralateral aspiration pneumonia were strongly associated with survival after open-window thoracostomy. This study highlights the importance of these factors in the management of empyema.