Chest tube drainage versus repeated therapeutic thoracentesis for the management of pleural infections: a retrospective multicentre propensity-matched study.

IF 8.5 Q1 RESPIRATORY SYSTEM
Marion Charron, Victor Roy, Christophe Gut-Gobert, Etienne-Marie Jutant, Louis Leclere, Baptiste Hourmant, Jean-Claude Meurice, Stéphane Jouneau, David Luque Paz
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引用次数: 0

Abstract

Background: Drainage of infected pleural fluid is pivotal in the management of pleural infections, either by chest tube drainage (CTD) or repeated therapeutic thoracocentesis (RTT), in association with the use of intrapleural fibrinolytic therapy (IPFT) and DNase.

Methods: The aim of this study was to compare the efficacy and the safety of these two methods of pleural drainage. We conducted a multicenter retrospective study, which included all the patients who was hospitalized for suspected pleural infection in three university hospitals between 2012 and 2021 drained by CTD or RTT. A propensity-score matching was performed to compare patients drained by RTT (RTT group) and by chest tube (CTD group) with adjunctive IPFT and DNase.

Results: Two hundred and twenty-nine patients with suspected pleural infection were included. After a propensity-score matching, 78 patients were included in the final analysis, divided in two groups of 39 patients each. Patients in RTT group had a reduced length of drainage (6 days [4.3-8] vs 9 [6.5-13], OR = 1.41, 95%CI [1.05-1.89]) and a reduced length of hospital stay (15 days [11.5-21.5] vs 21 [14-30.5], OR = 1.28, 95%CI [1.01-1.61]). There was no significant difference in mortality rates, surgical referral, relapse, and drainage-related complications between the two groups.

Conclusions: The management of pleural infections through RTT with IPFT and DNase appears to be as effective and as safe as CTD. Randomized controlled trials comparing RTT and CTD would be required to confirm these results.

胸管引流与反复胸腔穿刺治疗胸膜感染:一项多中心倾向匹配的回顾性研究。
背景:胸腔管引流(CTD)或反复治疗性胸腔穿刺术(RTT),以及胸膜内纤溶治疗(IPFT)和DNase的使用,对感染的胸腔液进行引流是胸膜感染治疗的关键。方法:比较两种胸腔引流方法的疗效和安全性。我们进行了一项多中心回顾性研究,纳入了2012年至2021年间在三所大学医院因疑似胸膜感染住院的所有患者,这些患者均采用CTD或RTT引流。采用倾向评分匹配法比较RTT组(RTT组)和胸管引流组(CTD组)患者辅助IPFT和DNase。结果:共纳入疑似胸膜感染患者229例。经过倾向评分匹配后,78名患者被纳入最终分析,分为两组,每组39名患者。RTT组患者引流时间缩短(6天[4.3-8]vs 9天[6.5-13],OR = 1.41, 95%CI[1.05-1.89]),住院时间缩短(15天[11.5-21.5]vs 21天[14-30.5],OR = 1.28, 95%CI[1.01-1.61])。两组在死亡率、手术转诊、复发率和引流相关并发症方面无显著差异。结论:IPFT和DNase联合RTT治疗胸膜感染与CTD治疗同样有效和安全。需要随机对照试验比较RTT和CTD来证实这些结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
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