TITLE:
Retrospective Comparative Analysis of Thoracic Empyema in Patients Older/Younger than 65
AUTHORS:
J. Hogan, V. Valtzoglou, N. Kostoulas, V. Pagliarulo, Marius Roman, J. P. Duffy, A. Majewski, E. Addae-Boateng, M. Hawari
KEYWORDS:
Empyema, Video Assisted Thoracoscopy, Elderly, Surgery, Outcomes
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.8 No.4,
December
26,
2018
ABSTRACT: Objectives:Thoracic empyema is characterized by the collection of infected fluid/pus in the pleural space. A multitude of etiologies and surgical approaches exist. The current
study aims to assess outcomes in elderly and young patients undergoing surgery
for thoracic empyema. Methods: A retrospective comparative
analysis was undertaken comparing outcomes in elderly and young patients undergoing surgery with an established diagnosis of empyema. Two groups were generated for comparison 1) patients older than 65 and 2) patients younger than 65. Demographics, comorbidities, post-operative complications, surgical approach and mortalities were compared between groups. Results: 526 patients underwent surgery for empyema during the study period (1993-2016). Group A (65) comprised 108 patients. With respect to group A, the median age at surgery was 45.30 years. Median
post-operative stay was 10.50 days (9.10 vs.
11.90 in VATS and open respectively). 30-day mortality in group A was 1.90% (3.30% vs. 0.47% in VATS and open respectively). Group B comprised 108 patients (median age 72.70 years). Median post-operative stay was 14.40 days (11.20 vs. 17.8, VATS vs. open, p = 0.001). Overall 30-day mortality was 8.30 % (7.5% vs.
9% in VATS and open respectively, p = 0.03). Conclusions: The associated mortality and in-patient stay was significantly greater in elderly cohorts when compared to younger. Minimal access approaches confer a number of advantages in elderly patients including shorter hospital stay and reduced mortality.