Factors influencing length of hospital stay in patients with bacterial pleural effusion

Respiration. 2005 Nov-Dec;72(6):587-93. doi: 10.1159/000087366. Epub 2005 Aug 3.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / metabolism
  • Empyema, Pleural / complications
  • Extracellular Fluid / metabolism
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Pleural Effusion / diagnosis
  • Pleural Effusion / etiology*
  • Pleural Effusion / therapy
  • Pneumonia, Bacterial / complications

Substances

  • Biomarkers