Early thoracentesis correlated with survival benefit in patients with spontaneous bacterial empyema

• Published in: Digestive and liver disease 2022-08, Vol.54 (8), p.1015-1020
• Main Authors: Albitar, Hasan Ahmad Hasan, Iyer, Vivek, Nelson, Darlene R., Kern, Ryan M., Leise, Michael, Gallo De Moraes, Alice
• Format: Article
• Language: English
• Subjects: Ascites; Cirrhosis; Hepatic hydrothorax; SBP; Spontaneous bacterial empyema
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2022.02.007

Spontaneous bacterial empyema (SBEM) is a rare complication of hepatic hydrothorax characterized by hydrothorax infection in the absence of pneumonia. We conducted this study to compare clinical outcomes in SBEM patients who underwent early thoracentesis (ET) (≤ 24 h from presentation) versus those who underwent delayed thoracentesis (DT). All patients diagnosed with SBEM at Mayo Clinic Rochester, Minnesota from January 1st 1999 to December 31st 2020 were reviewed. Demographics, pleural fluid studies, laboratory results and clinical outcomes were analyzed. A total of 54 SBEM patients (27 ET and 27 DT) were identified with 38 (70.4%) of patients presenting with right-sided effusions. Both groups had similar baseline characteristics. The rate of ICU admission was significantly higher in the DT group (15 (55.6%) vs. 7 (25.9%) patients, P = 0.027). Patients with DT had similar rate of AKI (11 (40.7%) vs. 6 (22.2%) patients, P = 0.074). In-hospital mortality (11 (40.7%) vs. 2 (7.4%) patients, P = 0.004), 3-month mortality (16 (59.3%) vs. 2 (7.4%) patients, P