Table 5 Surgical risk assessment
Lower risk | Higher risk |
|---|---|
Risk of Aspergillus empyema | |
Intrapulmonary cavity | Pleural involvement including thickening |
Solid lesion | Cavitary lesion with fungal ball or fluid level |
Smooth-walled cavity | Irregular or bumpy cavity surface (indicating fungal growth on surface of cavity) |
Single lesion or small, localised collection of several interrelated lesions | Extensive multicavity lesion |
Prior radiotherapy to proposed surgical site | |
Prior lobectomy or other thoracic surgery | |
Risk of space infection | |
Localised lesion and lobectomy or segmental resection | Second lobectomy or pneumonectomy |
Chest wall normal | Scoliosis or ankylosing spondylitis |
Other pleural/pulmonary disease preventing full lung mobilisation | |
Immunosuppression | |
Intrapleural spillage during surgery | |
Risk of overall poor outcome | |
Good pulmonary function | FEV1 <1.0. L/sec |
Young | Older ( >70 years) |
Well nourished | Thin, low BMI or reduced albumin |
No other significant comorbidities | Diabetes, other concurrent pulmonary infection (ie non-tuberculous mycobacterial or Pseudomonas infection) |
Other associated significant comorbidities (i.e. lymphoma, autoimmune hepatitis, organ transplantation) | |