Evidence map›Paper›PMID 37147024›Full record

ArticleBMJ open respiratory research2023

Parapneumonic effusions related to

Catherine Hyams, David T Arnold, Robyn Heath, Zahin Amin-Chowdhury, David Hettle, Gabriella Ruffino, Paul North, Charli Grimes, Norman K Fry, Philip Williams and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open respiratory research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. What is new in pleural infections?Breathe (Sheffield, England) · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 4 countries.

Catherine HyamsAcademic Respiratory Unit, University of Bristol, Bristol, UK catherine.hyams@bristol.ac.uk.ORCID 0000-0003-3923-1773
David T ArnoldAcademic Respiratory Unit, University of Bristol, Bristol, UK.
Robyn HeathVaccine and Testing Research Team, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Zahin Amin-ChowdhuryNational Infection Service, UKHSA, London, UK.
David HettleMicrobiology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Gabriella RuffinoAcute Medical Unit, Southmead Hospital, Bristol, UK.
Paul NorthMicrobiology Department, North Bristol NHS Trust, Westbury on Trym, Bristol, UK.
Charli GrimesAcademic Respiratory Unit, University of Bristol, Bristol, UK.
Norman K FryNational Infection Service, UKHSA, London, UK.
Philip WilliamsMicrobiology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Robert ChallenEngineering Mathematics, University of Bristol, Bristol, UK.
Leon DanonEngineering Mathematics, University of Bristol, Bristol, UK.
O Martin WilliamsMicrobiology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Shamez LadhaniNational Infection Service, UKHSA, London, UK.
Adam FinnBristol Vaccine Centre, University of Bristol, Bristol, UK.
Nick MaskellAcademic Respiratory Unit, University of Bristol, Bristol, UK.
University of Bristol · GBBiology of Infection · FRUniversity Hospitals Bristol NHS Foundation Trust · GBNorth Bristol NHS Trust · GBPennine Acute Hospitals NHS Trust · GB

Funding

Department of Health ACF-2015-25-002Department of Health DRF-2018-11-ST2-065
6 · The paper itself

Abstract

rationale

objectivesTo determine whether there were differences in pneumococcal disease presentation and severity associated with pleural infection.

methodsA retrospective cohort study, all adults ≥16 years admitted to three large UK hospitals, 2006-2018 with pneumococcal disease. 2477 invasive pneumococcal cases were identified: 459 SPE and 100 pleural infection cases. Medical records were reviewed for each clinical episode. Serotype data were obtained from the UK Health Security Agency national reference laboratory.

resultsIncidence increased over time, including non-PCV-serotype disease. PCV7-serotype disease declined following paediatric PCV7 introduction, but the effect of PCV13 was less apparent as disease caused by the additional six serotypes plateaued with serotypes 1 and 3 causing such parapneumonic effusions from 2011 onwards.Patients with pleural infection had a median survival 468 days (95% CI 340 to 590) vs 286 days (95% CI 274 to 335) in those with SPE. Pleural infection associated with frank pus had lower 90-day mortality than pleural infection without pus (0% vs 29%, p<0.0001). 90-day mortality could be predicted by baseline increased RAPID (Renal, Age, Purulence, Infection source, and Dietary factors) score (HR 15.01, 95% CI 1.24 to 40.06, p=0.049).

conclusionsPneumococcal infection continues to cause severe disease despite the introduction of PCVs. The predominance of serotype 1 and 3 in this adult UK cohort is in keeping with previous studies in paediatric and non-UK studies. Rising non-PCV serotype disease and limited impact of PCV13 on cases caused by serotypes 1 and 3 offset the reductions in adult pneumococcal parapneumonic effusion disease burden observed following the introduction of the childhood PCV7 programme.

Indexed as

Pleural EffusionPneumococcal InfectionsHumansPatient AcuityPneumococcal VaccinesRetrospective StudiesSerogroupStreptococcus pneumoniaeSuppurationPneumococcal Vaccinesbacterial infectionempyemapleural diseaserespiratory infection

Identifiers

PMID37147024
PMCPMC10163460
OpenAlexW4372291490

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.