Evaluation of Predictive Factors of Empyema in Children with Parapneumonic Pleural Effusion

Background Empyema is a complication of bacterial pneumonia which has a particular importance due to its significant morbidity and mortality in children. The aim of this study was to investigate the prognostic factors of empyema in children with parapneumonic pleural effusion. Materials and Methods: This retrospective cross-sectional study investigated all patients under ۱۴ years old with parapneumonic pleural effusion associated with community-acquired pneumonia (CAP) who were hospitalized in Tabriz Children's Hospital, Tabriz, Iran, between March ۲۰۱۶ and March ۲۰۲۰ (۴ years). Demographic and clinical characteristics were collected via medical records of patients and assessed as possible factors for empyema. These included: pre-treatments with ibuprofen, antibiotic therapy before admission, duration of the disease, underling diseases, fever, tachycardia, tachypnea, and also some paraclinical variables such as leukocytosis, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acidosis, blood, and pleural fluid culture results. Results: Empyema associated with parapneumonic pleural effusion was detected in ۴۷ patients (۴۱.۲%) of ۱۱۴ hospitalized children. Based on logistic regression modeling, ibuprofen consumption history (OR = ۷.۱۶; ۹۵% CI: ۱.۳۵-۳۷.۸۰; p = ۰.۰۲), tachypnea (OR = ۱۷.۱۳; ۹۵% CI: ۱.۶۳- ۱۷۹.۹۰; p = ۰.۰۱), and leukocytosis (OR= ۵.۶۶; ۹۵% CI: ۲.۱۰-۱۵.۲۴; p = ۰.۰۰۳) had a significant relationship with empyema occurrence. Conclusion Based on the findings of this study, the history of ibuprofen use, tachypnea, and leukocytosis were predictive factors for empyema in children with parapneumonic pleural effusion as a result of community-acquired pneumonia.

Keywords:

Children , Empyema , Parapneumonic pleural effusion , Pneumonia