Seventy-two patients with empyema were admitted to Pediatric ward, Kagoshima University Hospital, between April, 1974 and March, 1984.In order to investigate the risk factors in these patients, statistical analysis was carried out with Fisher's exact probability test.
Patients ranged in age from 12 days to 10 years, and 43 patients (59.7%) of them were less than 6 months.The affected side of the lung was seen more often in the right (61.1%).Positive cultures from pleural fluids were obtained in 53 cases (73.6%), and S.aureus grew in 47 cases (65.3%).Many strains of S.aureus showed the resistance to ABPC, EM, and TC.A few strains had acquired the resistance to aminoglycosides as GM, DKB, and TOB.
Nine patients with empyma died and the mortality rate was 12.5%. The risk factors of these patients were studied statistically, and were as follows: 1) infants less than 5 months (8 cases died in 39 cases, p=0.026), 2) infants affected in bilateral lungs (3 died in 5, p=0.012), 3) white blood cell count on admission under 10, 000/cmm (5 died in 12, p=0.0049), 4) complications as paralytic ileus or DIC (6 died in 9, p=0.0027).Forty-five cases had one risk factor and more, and in those 9 cases died (p=0.01).Further, 7 cases died in 9 cases with 2 risk factors and more (p=0.000059).
These data suggest that the risk factors are useful for inferring the prognosis of the patients with empyema even on admission, and if a patient has a risk factor, both adequate antibiotic therapy and systemic assistant therapy are to be done rapidly.