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Sonographic septation: a useful diagnostic predictor of complicated parapneumonic effusion
  1. Shan-Yueh Chang1,2,3,
  2. Ying-Chieh Chen1,
  3. Chen-Liang Tsai1,
  4. Shih-Wei Wu1,2,
  5. Chung-Kan Peng1,3,
  6. Chih-Hao Shen1,3,
  7. Yu-Ching Chou4,
  8. Chih-Feng Chian1
  1. 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
  2. 2Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
  3. 3Hyperbaric Oxygen Center, Division of Pulmonary Medicine and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
  4. 4School of Public Health, National Defense Medical Center, Taipei, Taiwan
  1. Correspondence to Dr Chih-Feng Chian, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; sonice3982{at}gmail.com

Abstract

Sonographic septation is associated with prolonged hospitalization and increased mortality in patients diagnosed with empyema. However, it is unknown whether sonographic septation is associated with complicated parapneumonic effusion (CPPE) or the need for invasive procedures among patients with pneumonia. In this retrospective study, we included 180 patients with non-purulent neutrophilic exudative pleural effusion secondary to pulmonary infections such as pneumonia and lung abscess. We performed univariate and multivariate logistic regression analyses, including baseline clinical characteristics, values from blood samples, and sonographic echogenicity, to identify variables correlated with CPPE and the need for invasive procedures. Seventy of the 180 included patients (38.89%) displayed sonographic septation. Multivariate logistic regression analysis identified that sonographic septation (adjusted OR (AOR)=3.38 (95% CI 1.64 to 6.98), p=0.001) and younger age (AOR=2.63 (95% CI 1.24 to 5.58), p=0.012) were independently associated with CPPE. With regard to treatment strategy, sonographic septation (AOR 9.06 (95% CI 3.71 to 22.11), p<0.001) and total serum protein level (AOR=1.80 (95% CI 1.13 to 2.86), p=0.013) were independently associated with the need for subsequent invasive procedures in patients with CPPE using multivariate logistic regression analysis. Sonographic septation is a useful predictor of CPPE and may imply the need for early invasive procedures.

  • pneumonia
  • pleural effusion
  • pulmonary surgical procedures

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors S-YC wrote the first draft of this article. All authors contributed to acquisition, analysis, and interpretation of data. The principal author takes full responsibility for the data presented in this study, analysis of data, conclusions, and conduct of the research.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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