Trends In Empyema Requiring Decortication in the West of Ireland

Title: Trends In Empyema Requiring Decortication in the West of Ireland
Author(s): A. White G. Keehan (presenter) R. Weedle A. Soo
Institution: Galway University Hospital - Department of Cardiothoracic Surgery
Poster: Click to view poster
Category: Lung Cancer/CF/ILD/Surgery
Abstract: The incidence of empyema is increasing worldwide, with changing causative organisms. The purpose of this study was to evaluate this trend in the West of Ireland.
This study includes a retrospective review on patients who underwent decortication in our unit from 2016 to 2018, with expanded data (cumulative study) from 2019 to 2020.

There were 36 patients included in this 4-year study period. 92% of patients presenting with empyema were male. 80% were smokers. Underlying pathology included parapneumonic effusion (61%), post traumatic/surgical collection (25%), malignancy (8.5%), or unknown (5.5%). 63% were referred from other hospitals within the Saolta group. 55% patients presenting with complex effusions were treated with a chest drain at presentation. Mean time to transfer to cardiothoracic surgery was 12 days. Most patients accepted for decortication had stage 2 (n=16) or stage 3 (n=20) empyema. Causative organisms in all cases with positive growth from cultures were staphylococcus aureus or streptococcus pneumonia. Mean length of stay under cardiothoracic care was 10.2 days.

This study highlights the importance of early recognition and treatment of empyema, along with early referral to appropriate teams.