Therapeutic strategy for acute pleural empyema: comparison between retrospective study and prospective study.

Objectives: The purpose of this study is to investigate the efficiency of therapeutic strategy for acute pleural empyema.

Methods: We retrospectively reviewed 121 acute empyema patients and evaluated the therapeutic strategy for acute pleural empyema. Then, we prospectively reviewed 114 acute pleural empyema patients based on the strategy.

Results: The duration from onset to hospitalization in our hospital is statistically shorter, and the mortality and the rate of stage 3 empyema patients are lower in the prospective study group (PSG) than in the retrospective study group (RSG). Retrospective study and prospective study found that surgical group (SG) had more favorable outcomes than non-surgical group (NSG). Although antibiotic treatment duration, hospital stay, and entire mortality were comparable in NSG of both study groups, mortality of patients with PS grade 4 was significantly lower in PSG. SG in PSG had more favorable outcomes than that in RSG, such as antibiotic treatment duration, hospital stay, complication, and mortality.

Conclusions: The good outcomes may be mainly caused by shorter duration from onset to hospitalization and shorter duration from hospitalization to operation. Operative management is an effective procedure for selected patients, and it is important to refer for thoracic surgical consultation earlier.