ArticleChest2016
Pleural Effusions at First ED Encounter Predict Worse Clinical Outcomes in Patients With Pneumonia.
Article in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 38 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Retrospective Review on Patients With Culture Negative Empyema
Preoperative Prediction of VATS Strategy in Parapneumonic Effusion
Who cites it
38 citing papers in PubMed.
- Nicotinamide phosphoribosyltransferase as a biomarker for the diagnosis of infectious pleural effusions.Scientific reports · 2021Trial
- Diagnosis of Parapneumonia Pleural Effusion with Serum and Pleural Fluid Cell-Free DNA.BioMed research international · 2019Trial
- Thirty-day hospital readmission and its determinants among patients with severe community-acquired pneumonia: a prospective cross-sectional study in Northwest Ethiopia.BMC infectious diseases · 2026Article
- Metagenomic next-generation sequencing for the diagnosis and evaluation of pediatric pleural effusion: a case series.BMC pulmonary medicine · 2026Article
- What is new in pleural infections?Breathe (Sheffield, England) · 2026Review
- Global point prevalence study to determine the variations in aetiology, management and outcomes of pleural infection: a protocol for the international multicentre study of pleural infection (the INTERMITTENT Study).BMJ open respiratory research · 2025Article
- A Practical Approach to Pleural Infection.Pulmonary therapy · 2025Article
- Pleural Infection: Diagnosis, Management, and Future Directions.Journal of clinical medicine · 2025Review
- Parapneumonic effusion is a risk factor for VTE in hospitalized patients with community-acquired pneumonia: a retrospective cohort study.Thrombosis journal · 2025Article
- Clinical outcome of urgent thoracoscopic surgery on complicated parapneumonic infection with short-term preoperative antibiotic usage.Journal of thoracic disease · 2025Article
- Risk Factors and Prognosis Analyses of Hospital-Acquired Pneumonia in Elderly Critically Ill Patients with Acute Ischemic Stroke Based on Machine Learning.Infection and drug resistance · 2025Article
- Understanding the Growing Burden of Malignant Pleural Effusion - Epidemiology, Healthcare Utilization, and Cost: A Canadian Perspective.Respiration; international review of thoracic diseases · 2025Article
- Ultrasound and Intrapleural Enzymatic Therapy for Complicated Pleural Effusion: A Case Series with a Literature Review.Journal of clinical medicine · 2024Review
- Front-door thoracic ultrasound in patients with community-acquired pneumonia to diagnose and predict pleural infection: a prospective study.ERJ open research · 2024Article
- ICU Utilization After Implementation of Minor Severe Pneumonia Criteria in Real-Time Electronic Clinical Decision Support.Critical care medicine · 2024Article
- Risk factors for pleural effusion in children with plastic bronchitis caused by pneumonia.Frontiers in pediatrics · 2024Article
- Pleural macrophages translocate to the lung during infection to promote improved influenza outcomes.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Seeing through the MIST: A Pathway Toward Optimal Intervention for Pleural Infection.American journal of respiratory and critical care medicine · 2023Article
- Diagnosis and management of pleural infection.Breathe (Sheffield, England) · 2023Review
- Empyema necessitans in a pediatric patient: A case study.International journal of surgery case reports · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundPleural effusions are present in 15% to 44% of hospitalized patients with pneumonia. It is unknown whether effusions at first presentation to the ED influence outcomes or should be managed differently.
methodsWe studied patients in seven hospital EDs with International Statistical Classification of Disease and Health Related Problems-Version 9 codes for pneumonia, or empyema, sepsis, or respiratory failure with secondary pneumonia. Patients with no confirmatory findings on chest imaging were excluded. Pleural effusions were identified with the use of radiographic imaging.
resultsOver 24 months, 4,771 of 458,837 adult ED patients fulfilled entry criteria. Among the 690 (14.5%) patients with pleural effusions, their median age was 68 years, and 46% were male. Patients with higher Elixhauser comorbidity scores (OR, 1.13 [95% CI, 1.09-1.18]; P < .001), brain natriuretic peptide levels (OR, 1.20 [95% CI, 1.12-1.28]; P < .001), bilirubin levels (OR, 1.07 [95% CI, 1.00-1.15]; P = .04), and age (OR, 1.15 [95% CI, 1.09-1.21]; P < .001) were more likely to have parapneumonic effusions. In patients without effusion, electronic version of CURB-65 (confusion, uremia, respiratory rate, BP, age ≥ 65 years accurately predicted mortality (4.7% predicted vs 5.0% actual). However, eCURB underestimated mortality in those with effusions (predicted 7.0% vs actual 14.0%; P < .001). Patients with effusions were more likely to be admitted (77% vs 57%; P < .001) and had a longer hospital stay (median, 2.8 vs 1.3 days; P < .001). After severity adjustment, the likelihood of 30-day mortality was greater among patients with effusions (OR, 2.6 [CI, 2.0-3.5]; P < .001), and hospital stay was disproportionately longer (coefficient, 0.22 [CI, 0.14-0.29]; P < .001).
conclusionsPatients with pneumonia and pleural effusions at ED presentation in this study were more likely to die, be admitted, and had longer hospital stays. Why parapneumonic effusions are associated with adverse outcomes, and whether different management of these patients might improve outcome, needs urgent investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.