ArticlePediatric surgery international2024
Contemporary use of fibrinolytics in the management of pediatric empyema.
Article in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- The impact of hospital volume on CT usage in the management of pediatric empyema.Pediatric surgery international · 2026Article
- Article
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4 authors.
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Abstract
backgroundThis study seeks to investigate the contemporary use and effectiveness of fibrinolysis as a first-line option in pediatric empyema.
methodsThe Pediatric Health Information System (PHIS) was queried to identify patients with empyema without fistula (2018-2023). First-line treatments were chest drainage (CD), chest drainage with fibrinolysis (CDF), and video-assisted thoracoscopic surgery/open decortication (VATS/OD). Outcomes between groups were compared using Kruskal-Wallis and Chi-Square tests. Multivariate generalized linear model was used to account for covariates.
results581 individuals/cases met inclusion criteria. CD accounted for 11.9% of cases, CDF for 67.6%, and VATS/OD for 20.7%. After adjusting for covariates differences in LOS were not significant (p = 0.393). Subsequent VATS/ODs were required in 6.9% of CDF cases, 8.9% of CD, and 3.3% of primary VATS/OD. Additionally, 32.5% of primary VATS/OD received adjuvant fibrinolysis. Complications were more often observed in the VATS/OD group compared to CD and CDF (11.7% vs 5.8% and 4.1% respectively; p = .008). There were no differences in 30-day readmission rate (VATS/OD:1.2%, CTD:1.5%, and CTDF:1%; p = 0.83).
conclusionFibrinolysis is now utilized as first-line treatment for most patients and as adjunct in other approaches. The findings justify further implementation as it is the less invasive first-line primary therapy in patients with empyema.
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