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 |