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Table 2 Short and long-term outcomes of OWT cohort

From: Short and long-term outcomes of surgical intervention for empyema in the post-fibrinolytic era

Cohort Outcomes, N = 18

 

Patients failed less invasive interventions

11

 VATS decortication only

4

 Failed VATS w/ conversion to open decortication

1

 VATS w/ later decortications ×2 and Amplatz

1

 Open decortication only

3

 Minimally invasive intervention only

2 (n = 1 EBV, n = 1 endobronchial stent)

Ribs resected (number), M ± SD; range

2.5 ± 1.2; 1–6

NPWT utilized, n (%)

9 (50.0)

Kerlix packing, n (%)

9 (50.0)

Delayed Closure, n (%)

 Yes

11 (61.1)

  Latissimus dorsi pedicled flap

6a

  Pectoralis major pedicled flap

1

  Free flap

2

  Re-approximation of surrounding tissue

2

 No, due to death

6 (33.3)

 Unknown, lost to follow up

1 (5.6)

Time from index surgery to delayed closure, M ± SD (months); range

4.8 ± 6.7; 3 days – 22.2 months

Patient Deceased, n (%)

 Yes, total

12 (66.6)

  Yes, within 30 days post-operatively

3

   -N = 2 Respiratory failure, sepsis

 

   -N = 1 Acute myocardial infarction

 

  Yes, within 90 days post-operatively

1

   -Tracheoinnominate fistula, hemorrhage, sepsis

 

  Yes, >  90 days post-op

8

 No

6 (33.3)

Major post-operative complication (within 90 days), n(%)

 Recurrent infection after closure

1 (5.6)

 DVT

1 (5.6)

 Pulmonary Embolism

1 (5.6)

 Stroke

1 (5.6)

 MI

1 (5.6)

 OR take-back

2 (11.1)

  -POD1: Hemorrhage

 

  -POD 7: Subcutaneous emphysema

 

Readmission

 Yes, total

7 (38.9)

  Yes, within 30 days

3

   -N = 1 scheduled closure

 

   -N = 1 fall, altered mental status

 

   -N = 1 dyspnea

 

  Yes, within 90 days

4

   -N = 2 scheduled closure

 

   -N = 1 aspiration pneumonia

 

   -N = 1 bleeding from OWT

 

 No

6 (33.3)

 Not applicable, death on primary admission

5 (27.8)

Overall Survival (months), M ± SD

24.0 ± 32.2

  1. a1 patient re-opened for recurrent infection and repeat OWT/Eloesser flaps
  2. Abbreviations: DVT deep vein thrombosis, EBV endobronchial valve, MI myocardial infarction, NPWT negative pressure wound therapy, VATS video-assisted thoracoscopic surgery