Journal Article

Factors Influencing Length of Hospital Stay in Patients with Bacterial Pleural Effusion

Alegre, J., Ruiz, E., Soriano, T., Alemán, C., Ferrer, A., Vázquez, A., Segura, R., Fernández de Sevilla, T., Carrasco, J.L.

2005

Overview

Background: Factors influencing length of hospital stay have been poorly analyzed in parapneumonic pleural effusions (PPE). Objectives: The aim of this work is to identify the variables that determine increased hospital stay in patients with infectious pleural effusion (PE). Patients and Methods: We analyzed 112 patients with PE: empyema, complicated parapneumonic and non-complicated parapneumonic. Epidemiologic, biochemical, therapeutic and radiological variables were analyzed. Correlations with hospital stay were studied using the Student’s t test, analysis of variance, Mann-Whitney U-test and linear regression model. Results: Among the 112 patients studied, there were 32 empyema, 50 complicated and 30 non-complicated parapneumonic cases. The median of length stay for all patients was 17 days. Longer hospitalization was required in patients with empyemic PE (p = 0.015), patients with underlying diseases (p = 0.003), those needing pleural drainage (p = 0.005) or decortication (p = 0.043) and those presenting unfavorable radiological outcome after treatment (p = 0.02). Biochemical parameters associated with longer hospital stay were elevated pleural fluid polymorphonuclear elastase (p = 0.001, r = 0.307) and lactate dehydrogenase (p = 0.001, r = 0.312). After linear regression analysis, only underlying disease, pleural drainage and pleural fluid polymorphonuclear elastase values remained in the model, explaining 23.1% of the variability of days of hospitalization. Conclusions: The patients with PPE and empyema who required longer hospitalization were those with purulent fluid, underlying disease, surgical drainage and/or decortication, with unfavorable radiological outcome and higher pleural fluid levels of lactate dehydrogenase and polymorphonuclear elastase.

• Publisher: Karger,S. Karger AG
• Subject: Adult / Aged / Bacteria / Bacterial diseases / Bacterial diseases of the respiratory system / Biological and medical sciences / Biomarkers - metabolism / Clinical Investigations / Empyema, Pleural - complications / Extracellular Fluid - metabolism / Health care / Hospitals / Human bacterial diseases / Humans / Infectious diseases / Length of Stay - statistics & numerical data / Male / Medical sciences / Middle Aged / Patients / Pleural Effusion - diagnosis / Pleural Effusion - etiology / Pleural Effusion - therapy / Pneumology / Pneumonia, Bacterial - complications / Respiratory system : syndromes and miscellaneous diseases / Risk factors