Aim:
To study (a) the clinical, etiological profile and outcome, (b) the risk factors associated with poor prognosis in empyema thoracis among children aged 1-month to 12 years admitted in a tertiary care center.
Study design:
Nested case control study / descriptive study.
Setting:
Institute of Child Health & Hospital for Children, Chennai.
Study Period:
June 2003 – October 2004. Study population: Cases: Children with empyema thoracis who have recovered with complications / gone in for decortication. Controls: Children with empyema thoracis who recovered without complications.
Sample Size:
106 (cases 36, controls 70).
Risk factors:
Nutritional status, duration of illness more than 7 days prior to ICD, previous treatment, congenital anomalies and associated illness, microorganism, locality and age of the child.
Methods:
The children with empyema thoracis admitted were followed-up till discharge / death, the data were collected and analyzed. Statistical analysis: Odds Ratio with 95% confidence interval [OR (95% CI)] by univariate analysis.
Results:
Out of 106 children, 103 (97%) had fever, 89 (84%) had cough, 85 (80%) had difficulty in breathing, 12 (11%) had abdominal distension and 7 (6.5%) had chest pain. Empyema was right sided in 62 (58.5%) children. Males 54% of total cases and less than 3 years were 55%. Isolation of organism was possible in 37 (35%) cases gram +ve 49%, gram –ve 51%, 70 (66.1%) cases recovered without complications, 36 (33.9%) recovered with complications / decortication or died. We have found that under nutrition [OR 3.54 (95% CI:1.31-9.39)], duration of illness more than 7 days [OR 2.74 (95% CI:1.19-6.29)] and previous treatment with antibiotics [OR 2.84 (95% CI:1.18-6.92)] were independent task factors for complications and mortality.
Conclusion:
Under nutrition, duration of illness more than 7 days and history of previous treatment are associated with poor prognosis in empyema thoracis in children.
Key words:
Empyema thoracis, risk factors.
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