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, micro-organisms, 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.

Keywords:

Empyema thoracis, risk factors

Ooty Pedicon 2005 - Conference Abstracts.Pediatric Oncall [serial online] 2005 [cited 01 December 2005];2. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
empyema_thoracis.asp