Materiały źródłowe

• #1 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  Pleural empyema represents a significant healthcare burden due to extended hospital admissions and potential requirement for surgical intervention. This study aimed to assess changes in incidence and management of pleural empyema in England over the past 10 years and the potential impact of influenza on rates. […] Between April 2008 and March 2018 there were 55530 patients admitted with pleural empyema. There was male predominance (67% versus 33%), which increased with age. Cases have increased significantly from 4447 in 2008 to 7268 in 2017. […] Rates of empyema admissions in England have increased steadily with a seasonal variation that is temporally related to influenza incidence. Patient-level serological data from a prospective study support the hypothesis that influenza may play a pathogenic role in empyema development.

• #2 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  Rates of pleural empyema are increasing in English hospitals without any improvement in patient outcomes. This study also found that male predominance of empyema increased with age, and rates increased in winter and during peaks of influenza. […] Epidemiological studies have suggested that the incidence of pleural empyema is increasing. […] The link between viral influenza and secondary bacterial pneumonia has been demonstrated in epidemiological, observational and animal studies. The relationship between influenza and empyema is less well described, although it has a biological and epidemiological basis. […] This study assessed the changes in rates of pleural empyema in England over the past decade and possible association with influenza. Data from HES have shown a significant increase of empyema rates over the study period, as well as average seasonal increases in winter months of 25%.

• #2

  https://discovery.ucl.ac.uk/id/eprint/10171023/

  Epidemiology of pleural empyema in English hospitals and the impact of influenza. […] This study aimed to assess changes in incidence and management of pleural empyema in England over the past 10 years and the potential impact of influenza on rates. […] Between April 2008 and March 2018 there were 55 530 patients admitted with pleural empyema. […] Cases have increased significantly from 4447 in 2008 to 7268 in 2017. […] Rates of empyema admissions in England have increased steadily with a seasonal variation that is temporally related to influenza incidence. […] Patient-level serological data from a prospective study support the hypothesis that influenza may play a pathogenic role in empyema development.

• #3 Parapneumonic Pleural Effusions and Empyema Thoracis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/298485-overview

  A study of US hospitalization data found that in 1996, the national hospitalization rate for parapneumonic empyema-related diagnoses was 3.04 per 100,000; by 2008, it had increased to 5.98 per 100,000, and by 2016, it had increased to 11.1 per 100,000. […] No good estimates are available on the international incidence of pneumonia. The World Health Organization (WHO) cited a figure of 4.2 million for cases involving death from lower respiratory tract infections in 2004. From this figure, it is possible to extrapolate the incidence of pleural effusions and empyema using a US estimate, but caution is advised because lack of treatment and delayed treatment in developing countries may skew the international incidence upward. […] In a 2021 report from the American College of Chest Physicians (ACCP), 60% of the hospitalizations related to pleural infections were found to occur in the 18- to 64-year-old age group.

• #4 Epidemiology and prognostic factors of pleural empyema | Thorax

  https://bibliotheek.ehb.be:2672/content/76/11/1117

  Infection of the pleural cavity invariably leads to hospitalisation, and a fatal outcome is not uncommon. Our aim was to study the epidemiology of pleural empyema on a nationwide basis in the whole population and in three subgroups of patients, namely post-lung resection, associated cancer and those with no surgery and no cancer. […] There were 25512 hospitalisations for pleural empyema. The annual rate was 7.15 cases per 100000 habitants in 2013 and increased to 7.75 cases per 100000 inhabitants in 2017. […] Empyema is increasing in incidence. Factors associated with mortality are recent lung resection and associated diagnosis of cancer.

• #5 Epidemiology and prognostic factors of pleural empyema – Archive ouverte HAL

  https://hal.science/hal-03842900/

  Epidemiology and prognostic factors of pleural empyema […] Our aim was to study the epidemiology of pleural empyema on a nationwide basis in the whole population and in three subgroups of patients, namely post-lung resection, associated cancer and those with no surgery and no cancer. […] There were 25512 hospitalisations for pleural empyema. The annual rate was 7.15 cases per 100000 habitants in 2013 and increased to 7.75 cases per 100000 inhabitants in 2017. […] Empyema is increasing in incidence. Factors associated with mortality are recent lung resection and associated diagnosis of cancer.

• #6 Current status and prospect of medical and surgical management for thoracic empyema – Higuchi – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/37523/html

  Recent epidemiologic studies have indicated that the incidence of empyema has been increasing during the last few decades. In 2016 in Japan, 2,833 cases of empyema were reported and hospital mortality rate was 6.9%. In the United States, the estimated incidence of parapneumonic empyema is 6 cases per 100,000 people, and the hospital mortality rate in the adult population is approximately 16.1%. Risk factors of empyema include diabetes mellitus, gastroesophageal reflux, poor dental hygiene, chronic lung disease, alcohol abuse, and so on. Empyema may develop as a complication of pulmonary infection, thoracic and abdominal surgery, trauma, and iatrogenic procedures. However, pleural infection may also occur as a primary infection without pneumonia.

• #7 Parapneumonic Pleural Effusions and Empyema Thoracis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/298485-overview

  In the 2021 ACCP report, a male predominance in adult pleural infections was noted. […] No specific ethnic or racial predisposition is recognized for empyema; however, a larger number of ethnic minorities have limited financial resources, less access to healthcare, and more comorbidities, which, in turn, may increase their risk of pneumonia, pleural effusions, and empyema.

• #8 Thoracic Empyema | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27359

  In the US, the incidence of parapneumonic empyema is estimated to be 6 cases per 100,000. In-hospital mortality in patients older than 65 is approximately 16.1%. […] Between 2005 and 2014, 150,469 patients aged 18 and older were admitted to US hospitals for pleural infections. The average age of these patients was 58.3 years; 68% of patients were men. White patients accounted for 79.3% of the admissions, and 4.4% of patients presented with either severe sepsis or septic shock.

• #9

  https://mansapublishers.com/index.php/ijch/article/view/612?articlesBySameAuthorPage=26

  Empyema thoracic is known to have a variable age group affection, causative agents and controversy regarding primary mode of management. […] The aim of this study was to study the epidemiology, management strategies including investigations and outcome of empyema in the children. […] Among study population, male to female ratio was 1.48:1. […] Total 31.57% of the cultures were positive. […] There was a significant correlation between duration of illness (7 days) and advancement in the stage of empyema (p 0.0001). […] Overall outcome of empyema was excellent, mortality was less than 1.5%, with overwhelming sepsis. […] Staging of empyema at initiation of treatment helps in proper management of patients.

• #10 Empyema and Abscess Pneumonia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/807499-overview

  Most empyemas are complications of pneumonia, but up to 20% are secondary to iatrogenic causes, including but not limited to, thoracic surgeries, chest tube insertion, or thoracentesis. Three percent of empyemas are estimated to occur as complications of chest trauma. […] A population study revealed that nearly 65% of individuals with parapneumonic empyema are male. […] There is an increased risk of parapneumonic empyema with extremes of age with rates of 7.6 and 9.9 cases per 100,000 for ages younger than 5 years and older than 64 years, respectively. Rates for empyema between ages of 5 and 64 years range from 1.9-5.4 cases per 100,000.

• #11 Parapneumonic Pleural Effusions and Empyema Thoracis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/298485-overview

  A study of US hospitalization data found that in 1996, the national hospitalization rate for parapneumonic empyema-related diagnoses was 3.04 per 100,000; by 2008, it had increased to 5.98 per 100,000, and by 2016, it had increased to 11.1 per 100,000. […] No good estimates are available on the international incidence of pneumonia. The World Health Organization (WHO) cited a figure of 4.2 million for cases involving death from lower respiratory tract infections in 2004. From this figure, it is possible to extrapolate the incidence of pleural effusions and empyema using a US estimate, but caution is advised because lack of treatment and delayed treatment in developing countries may skew the international incidence upward. […] In a 2021 report from the American College of Chest Physicians (ACCP), 60% of the hospitalizations related to pleural infections were found to occur in the 18- to 64-year-old age group.

• #12 Pleural empyema epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pleural_empyema_epidemiology_and_demographics

  The incidence and prevalence of empyema has been increasing over the past 15 years. More than 40% of patients have preexisting comorbidities. […] There have been a 26% increase in age and sex-standardized incidence rate from 8.7 per 100,000 person-years in 1997 to 11.8 per 100,000 person-years in 2011. This increment is most notably among older people aged 80 years (87.3% [from 20.4 per 100,000 in 1997 to 38.2 per 100,000 in 2011]) compared with people aged 40 to 64 years (27.8% [from 10.7 per 100,000 in 1997 to 12.6 per 100,000 in 2011]). […] Men are more commonly affected with empyema than women. The male to female ratio is approximately 1.7- to 3.1-fold higher in men than in women. […] The rate of patients with empyema requiring hospitalization appears to be increasing in western populations, however updated population-based data are scanty. The few available data on adult empyema have reported increases between 30% and 97% over the past 15 years in the United States and Canada. […] There is however a decreasing trend in the median days of hospital stay from 22 days 17 days.

• #13 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  Rates of pleural empyema are increasing in English hospitals without any improvement in patient outcomes. This study also found that male predominance of empyema increased with age, and rates increased in winter and during peaks of influenza. […] Epidemiological studies have suggested that the incidence of pleural empyema is increasing. […] The link between viral influenza and secondary bacterial pneumonia has been demonstrated in epidemiological, observational and animal studies. The relationship between influenza and empyema is less well described, although it has a biological and epidemiological basis. […] This study assessed the changes in rates of pleural empyema in England over the past decade and possible association with influenza. Data from HES have shown a significant increase of empyema rates over the study period, as well as average seasonal increases in winter months of 25%.

• #14 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  Pleural empyema represents a significant healthcare burden due to extended hospital admissions and potential requirement for surgical intervention. This study aimed to assess changes in incidence and management of pleural empyema in England over the past 10 years and the potential impact of influenza on rates. […] Between April 2008 and March 2018 there were 55530 patients admitted with pleural empyema. There was male predominance (67% versus 33%), which increased with age. Cases have increased significantly from 4447 in 2008 to 7268 in 2017. […] Rates of empyema admissions in England have increased steadily with a seasonal variation that is temporally related to influenza incidence. Patient-level serological data from a prospective study support the hypothesis that influenza may play a pathogenic role in empyema development.

• #15 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  This is the first epidemiological assessment of pleural empyema in England which has demonstrated that incidence is rising in the elderly. The male predominance of the condition increases with age for reasons that remain unclear. In addition, this is the first study to show the marked increase in empyema incidence in winter months which is temporally associated with influenza.

• #16 Parapneumonic Pleural Effusions and Empyema Thoracis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/298485-overview

  Hospital discharge data indicate that in the United States, approximately 1.3 million patients are hospitalized with pneumonia every year. The prevalence of parapneumonic effusions is dependent, in part, on the organism involved. […] Overall, pleural effusions are seen in about 35-40% of patients with bacterial pneumonia or anaerobic pneumonia, with a prevalence approaching 60% in pneumococcal pneumonia. Complicated pleural effusions are more common with anaerobic pleuropulmonary infections. This results in an estimated 500,000-750,000 patients with parapneumonic effusions annually. No good estimates are available regarding how many of these patients proceed to complicated effusions or empyema, but in small series, approximately 5-10% have been found require drainage or a surgical procedure.

• #17 Parapneumonic Pleural Effusions and Empyema Thoracis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/298485-overview

  Hospital discharge data indicate that in the United States, approximately 1.3 million patients are hospitalized with pneumonia every year. The prevalence of parapneumonic effusions is dependent, in part, on the organism involved. […] Overall, pleural effusions are seen in about 35-40% of patients with bacterial pneumonia or anaerobic pneumonia, with a prevalence approaching 60% in pneumococcal pneumonia. Complicated pleural effusions are more common with anaerobic pleuropulmonary infections. This results in an estimated 500,000-750,000 patients with parapneumonic effusions annually. No good estimates are available regarding how many of these patients proceed to complicated effusions or empyema, but in small series, approximately 5-10% have been found require drainage or a surgical procedure.

• #18 Empyema: ED Presentation, Evaluation, and Management – emDocs

  https://www.emdocs.net/empyema-ed-presentation-evaluation-and-management/

  Since the advent and widespread use of antibiotics, parapneumonic effusions and empyema as a complication of pneumonia have an incidence rate of approximately 2-3%. […] However, some epidemiological studies have suggested that rates are beginning to slowly rise. One study, involving over four-thousand patients with empyema, showed a 2.8% increase in incident per year between 1987 and 2004. […] In addition, a Canadian study showed a 2.2 fold increase in incidence among those less than 19 years old and 1.2 fold increase in those greater than 19 years old. […] Patients hospitalized with pneumonia are at greatest risk, with one study showing that 20-40% of admitted pneumonia have/develop a parapneumonic effusion with 5-10% of these cases developing empyema.

• #19 Epidemiology, clinical presentation, and evaluation of parapneumonic effusion and empyema in children – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-presentation-and-evaluation-of-parapneumonic-effusion-and-empyema-in-children

  Epidemiology, clinical presentation, and evaluation of parapneumonic effusion and empyema in children […] Parapneumonic effusions are seen in approximately 2 to 12 percent of children with pneumonia and up to 28 percent of those requiring hospitalization. […] The epidemiology, etiology, pathophysiology, clinical presentation, and evaluation of parapneumonic effusion and empyema in children will be reviewed here.

• #20

  https://www.ijpediatrics.com/index.php/ijcp/article/view/4441

  Empyema thoracis refers to infection and pus formation within the pleural space in the thorax. It is estimated that 0.6% of childhood pneumonias progress to empyema, affecting 3.3 per 100000 children. […] The changing face of pleural empyema in children: epidemiology and management. […] Empyema associated with community-acquired pneumonia: a pediatric investigator’s collaborative network on infections in Canada (PICNIC) study.

• #21 Empyema and Abscess Pneumonia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/807499-overview

  The rates of lung abscess have dropped significantly since the development of antibiotics. The frequency of lung abscess varies depending on underlying comorbidities and occurs most frequently in individuals with risk factors for aspiration (stroke, dementia, alcoholism, gastric reflux, and poorly controlled epilepsy), immunocompromise, malignancy, intravenous drug use, poor dental hygiene, and diabetes mellitus. […] In the 1940s, the rates of empyema had dropped precipitously with the advent of antibiotics, but, from 1996 to 2008, the rate of empyema nearly doubled across all age groups. This increase is partly explained by the rapid increase of antibiotic resistance but, interestingly, is theorized to have occurred secondary to a replacement phenomenon. The heptavalent pneumococcal vaccine had dramatically decreased the overall incidence of pneumococcal infections but had increased the incidence of nonvaccine pneumococcal serotypes 1, 3, and 19A and nonpneumococcal infections, especially Staphylococcus aureus, that are thought to confer a higher conversion from pneumonia to complicated pneumonia and empyema.

• #22 Current status and prospect of medical and surgical management for thoracic empyema – Higuchi – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/37523/html

  Recent epidemiologic studies have indicated that the incidence of empyema has been increasing during the last few decades. In 2016 in Japan, 2,833 cases of empyema were reported and hospital mortality rate was 6.9%. In the United States, the estimated incidence of parapneumonic empyema is 6 cases per 100,000 people, and the hospital mortality rate in the adult population is approximately 16.1%. Risk factors of empyema include diabetes mellitus, gastroesophageal reflux, poor dental hygiene, chronic lung disease, alcohol abuse, and so on. Empyema may develop as a complication of pulmonary infection, thoracic and abdominal surgery, trauma, and iatrogenic procedures. However, pleural infection may also occur as a primary infection without pneumonia.

• #23 Pleural empyema epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pleural_empyema_epidemiology_and_demographics

  The incidence and prevalence of empyema has been increasing over the past 15 years. More than 40% of patients have preexisting comorbidities. […] There have been a 26% increase in age and sex-standardized incidence rate from 8.7 per 100,000 person-years in 1997 to 11.8 per 100,000 person-years in 2011. This increment is most notably among older people aged 80 years (87.3% [from 20.4 per 100,000 in 1997 to 38.2 per 100,000 in 2011]) compared with people aged 40 to 64 years (27.8% [from 10.7 per 100,000 in 1997 to 12.6 per 100,000 in 2011]). […] Men are more commonly affected with empyema than women. The male to female ratio is approximately 1.7- to 3.1-fold higher in men than in women. […] The rate of patients with empyema requiring hospitalization appears to be increasing in western populations, however updated population-based data are scanty. The few available data on adult empyema have reported increases between 30% and 97% over the past 15 years in the United States and Canada. […] There is however a decreasing trend in the median days of hospital stay from 22 days 17 days.

• #24 Epidemiology and management of empyema thoracic by hepatic abscess

  https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=73380

  Epidemiology and management of empyema thoracic by hepatic abscess […] To determine the epidemiology and to evaluate the management of patients with empyema by LA. […] The prevalence of diabetes is associated with a higher mortality in LA. […] There are reports of some amoebic LA that cause pleural empyema but very few cases of pyogenic etiology have been documented. […] The prevalence of Klebsiella pneumoniae with more nonspecific clinical features may explain the delay in diagnosis.

• #25 Pleural empyema | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/pleural-empyema-1?embed_domain=hackmd.io%252f%2540yipuafecsl2jsu8smr5njq%252fbnjhjgjghjghjghfavicon.icofavicon.icofavicon.ico&lang=us

  Empyemas are usually the complication of another underlying abnormality, and thus demographics will follow those of the primary cause, e.g. pneumonia, subdiaphragmatic abscess, esophageal perforation, etc. […] Patients with HIV/AIDS are more likely to have pneumonia, and in turn are more likely to develop empyema, which may occur in 5% of cases of pneumonia 5.

• #26 Epidemiology and prognostic factors of pleural empyema | Thorax

  https://bibliotheek.ehb.be:2672/content/76/11/1117

  Infection of the pleural cavity invariably leads to hospitalisation, and a fatal outcome is not uncommon. Our aim was to study the epidemiology of pleural empyema on a nationwide basis in the whole population and in three subgroups of patients, namely post-lung resection, associated cancer and those with no surgery and no cancer. […] There were 25512 hospitalisations for pleural empyema. The annual rate was 7.15 cases per 100000 habitants in 2013 and increased to 7.75 cases per 100000 inhabitants in 2017. […] Empyema is increasing in incidence. Factors associated with mortality are recent lung resection and associated diagnosis of cancer.

• #27 Pleural empyema epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pleural_empyema_epidemiology_and_demographics

  The incidence and prevalence of empyema has been increasing over the past 15 years. More than 40% of patients have preexisting comorbidities. […] There have been a 26% increase in age and sex-standardized incidence rate from 8.7 per 100,000 person-years in 1997 to 11.8 per 100,000 person-years in 2011. This increment is most notably among older people aged 80 years (87.3% [from 20.4 per 100,000 in 1997 to 38.2 per 100,000 in 2011]) compared with people aged 40 to 64 years (27.8% [from 10.7 per 100,000 in 1997 to 12.6 per 100,000 in 2011]). […] Men are more commonly affected with empyema than women. The male to female ratio is approximately 1.7- to 3.1-fold higher in men than in women. […] The rate of patients with empyema requiring hospitalization appears to be increasing in western populations, however updated population-based data are scanty. The few available data on adult empyema have reported increases between 30% and 97% over the past 15 years in the United States and Canada. […] There is however a decreasing trend in the median days of hospital stay from 22 days 17 days.

• #28 Empyema and Abscess Pneumonia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/807499-overview

  Most empyemas are complications of pneumonia, but up to 20% are secondary to iatrogenic causes, including but not limited to, thoracic surgeries, chest tube insertion, or thoracentesis. Three percent of empyemas are estimated to occur as complications of chest trauma. […] A population study revealed that nearly 65% of individuals with parapneumonic empyema are male. […] There is an increased risk of parapneumonic empyema with extremes of age with rates of 7.6 and 9.9 cases per 100,000 for ages younger than 5 years and older than 64 years, respectively. Rates for empyema between ages of 5 and 64 years range from 1.9-5.4 cases per 100,000.

• #29 Epidemiology and prognostic factors of pleural empyema | Thorax

  https://bibliotheek.ehb.be:2672/content/76/11/1117

  Infection of the pleural cavity invariably leads to hospitalisation, and a fatal outcome is not uncommon. Our aim was to study the epidemiology of pleural empyema on a nationwide basis in the whole population and in three subgroups of patients, namely post-lung resection, associated cancer and those with no surgery and no cancer. […] There were 25512 hospitalisations for pleural empyema. The annual rate was 7.15 cases per 100000 habitants in 2013 and increased to 7.75 cases per 100000 inhabitants in 2017. […] Empyema is increasing in incidence. Factors associated with mortality are recent lung resection and associated diagnosis of cancer.

• #30 Empyema and Abscess Pneumonia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/807499-overview

  Most empyemas are complications of pneumonia, but up to 20% are secondary to iatrogenic causes, including but not limited to, thoracic surgeries, chest tube insertion, or thoracentesis. Three percent of empyemas are estimated to occur as complications of chest trauma. […] A population study revealed that nearly 65% of individuals with parapneumonic empyema are male. […] There is an increased risk of parapneumonic empyema with extremes of age with rates of 7.6 and 9.9 cases per 100,000 for ages younger than 5 years and older than 64 years, respectively. Rates for empyema between ages of 5 and 64 years range from 1.9-5.4 cases per 100,000.

• #31 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  The risk of empyema in children seems to be comparable to adults. Using the United States Kids’ Inpatient Database the incidence is calculated to be around 1.5% in children hospitalized for community acquired pneumonia, although percentages up to 30% have been reported in individual hospitals, a difference which may be explained by an transient endemic of highly invasive serotype or overdiagnosis of small parapneumonic effusions. […] Although pneumococcal vaccination dramatically decreased the incidence of pneumonia in children, it did not have this effect on the incidence of complicated pneumonia. It has been shown that the incidence of empyema in children was already on the rise at the end of the 20th century, and that the widespread use of pneumococcal vaccination did not slow down this trend.

• #32 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  The risk of empyema in children seems to be comparable to adults. Using the United States Kids’ Inpatient Database the incidence is calculated to be around 1.5% in children hospitalized for community acquired pneumonia, although percentages up to 30% have been reported in individual hospitals, a difference which may be explained by an transient endemic of highly invasive serotype or overdiagnosis of small parapneumonic effusions. […] Although pneumococcal vaccination dramatically decreased the incidence of pneumonia in children, it did not have this effect on the incidence of complicated pneumonia. It has been shown that the incidence of empyema in children was already on the rise at the end of the 20th century, and that the widespread use of pneumococcal vaccination did not slow down this trend.

• #33 Empyema and Abscess Pneumonia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/807499-overview

  The rates of lung abscess have dropped significantly since the development of antibiotics. The frequency of lung abscess varies depending on underlying comorbidities and occurs most frequently in individuals with risk factors for aspiration (stroke, dementia, alcoholism, gastric reflux, and poorly controlled epilepsy), immunocompromise, malignancy, intravenous drug use, poor dental hygiene, and diabetes mellitus. […] In the 1940s, the rates of empyema had dropped precipitously with the advent of antibiotics, but, from 1996 to 2008, the rate of empyema nearly doubled across all age groups. This increase is partly explained by the rapid increase of antibiotic resistance but, interestingly, is theorized to have occurred secondary to a replacement phenomenon. The heptavalent pneumococcal vaccine had dramatically decreased the overall incidence of pneumococcal infections but had increased the incidence of nonvaccine pneumococcal serotypes 1, 3, and 19A and nonpneumococcal infections, especially Staphylococcus aureus, that are thought to confer a higher conversion from pneumonia to complicated pneumonia and empyema.

• #34

  https://journals.lww.com/pidj/fulltext/2011/06000/laboratory_based,_2_year_surveillance_of_pediatric.6.aspx

  In October 2006, the heptavalent pneumococcal conjugate vaccine was included in the Madrid vaccination calendar, warranting serotype (St) surveillances in pneumococcal pediatric parapneumonic empyema (PPE). […] A prospective 2-year (May 2007-April 2009) laboratory-confirmed PPE surveillance was performed in 22 hospitals. […] We identified 138 PPEs. Pneumococcal etiology was confirmed in 100 cases: 38 by culture, 62 by PCR. […] Total rates of St 1 (38%), St 5 (15%), and St 7F (9%) would have been over-represented considering only positive-culture PPEs (n = 38), by increasing to 52.6% (St 1), 23.7% (St 5), and 10.5% (St 7F). […] PCR is essential for determining the specific etiology of PPE.

• #35 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  The incidence of pleural empyema and the prevalence of specific causative microorganisms varies depending on the source of infection (community acquired vs. hospital acquired pneumonia), the age of the patient and host immune status. Risk factors include alcoholism, drug use, HIV infection, neoplasm and pre-existent pulmonary disease. Pleural empyema was found in 0.7% of 3675 patients needing hospitalization for a community acquired pneumonia in a recent Canadian single-center prospective study. […] A multi-center study from the UK including 430 adult patients with community acquired pleural empyema found negative pleural-fluid cultures in 54% of patients, Streptococcus milleri group in 16%, Staphylococcus aureus in 12%, Streptococcus pneumoniae in 8%, other Streptococci in 7% and anaerobic bacteria in 8%.

• #36 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  The incidence of pleural empyema and the prevalence of specific causative microorganisms varies depending on the source of infection (community acquired vs. hospital acquired pneumonia), the age of the patient and host immune status. Risk factors include alcoholism, drug use, HIV infection, neoplasm and pre-existent pulmonary disease. Pleural empyema was found in 0.7% of 3675 patients needing hospitalization for a community acquired pneumonia in a recent Canadian single-center prospective study. […] A multi-center study from the UK including 430 adult patients with community acquired pleural empyema found negative pleural-fluid cultures in 54% of patients, Streptococcus milleri group in 16%, Staphylococcus aureus in 12%, Streptococcus pneumoniae in 8%, other Streptococci in 7% and anaerobic bacteria in 8%.

• #37

  https://mansapublishers.com/index.php/ijch/article/view/612?articlesBySameAuthorPage=26

  Empyema thoracic is known to have a variable age group affection, causative agents and controversy regarding primary mode of management. […] The aim of this study was to study the epidemiology, management strategies including investigations and outcome of empyema in the children. […] Among study population, male to female ratio was 1.48:1. […] Total 31.57% of the cultures were positive. […] There was a significant correlation between duration of illness (7 days) and advancement in the stage of empyema (p 0.0001). […] Overall outcome of empyema was excellent, mortality was less than 1.5%, with overwhelming sepsis. […] Staging of empyema at initiation of treatment helps in proper management of patients.

• #38

  https://journals.lww.com/pidj/fulltext/2011/06000/laboratory_based,_2_year_surveillance_of_pediatric.6.aspx

  In October 2006, the heptavalent pneumococcal conjugate vaccine was included in the Madrid vaccination calendar, warranting serotype (St) surveillances in pneumococcal pediatric parapneumonic empyema (PPE). […] A prospective 2-year (May 2007-April 2009) laboratory-confirmed PPE surveillance was performed in 22 hospitals. […] We identified 138 PPEs. Pneumococcal etiology was confirmed in 100 cases: 38 by culture, 62 by PCR. […] Total rates of St 1 (38%), St 5 (15%), and St 7F (9%) would have been over-represented considering only positive-culture PPEs (n = 38), by increasing to 52.6% (St 1), 23.7% (St 5), and 10.5% (St 7F). […] PCR is essential for determining the specific etiology of PPE.

• #39 The national programme for enhanced pneumococcal; BCES-Modelling; Newcastle University

  https://research.ncl.ac.uk/bces-modelling/biologicalclinicalandenvironmentalsystems/thenationalprogrammeforenhancedpneumococcal/

  The national programme for enhanced pneumococcal surveillance of complicated pneumococcal pneumonia and empyema in UK children. […] The incidence of paediatric empyema thoracis has risen dramatically over the last decade and Streptococcus pneumoniae serotype 1 has been identified as the principal pathogen in the UK. […] This project is intended to monitor the changing incidence of pneumococcal empyema thoracis in children throughout the UK, to determine the prevalence of different pneumococcal serotypes over time and to explore epidemiological and genetic factors. […] We propose to explore the following hypotheses: That the incidence of pneumococcal empyema will continue to increase in British children. That the increase will occur as a result of a progressive increase in serotype 1 disease which commenced before the introduction of the conjugate vaccine, as well as increase in disease from other non-vaccine serotypes.

• #40 The national programme for enhanced pneumococcal; BCES-Modelling; Newcastle University

  https://research.ncl.ac.uk/bces-modelling/biologicalclinicalandenvironmentalsystems/thenationalprogrammeforenhancedpneumococcal/

  The national programme for enhanced pneumococcal surveillance of complicated pneumococcal pneumonia and empyema in UK children. […] The incidence of paediatric empyema thoracis has risen dramatically over the last decade and Streptococcus pneumoniae serotype 1 has been identified as the principal pathogen in the UK. […] This project is intended to monitor the changing incidence of pneumococcal empyema thoracis in children throughout the UK, to determine the prevalence of different pneumococcal serotypes over time and to explore epidemiological and genetic factors. […] We propose to explore the following hypotheses: That the incidence of pneumococcal empyema will continue to increase in British children. That the increase will occur as a result of a progressive increase in serotype 1 disease which commenced before the introduction of the conjugate vaccine, as well as increase in disease from other non-vaccine serotypes.

• #41 Surveillance of pediatric parapneumonic effusion/empyema in New Zealand – University of Otago

  https://otago-researchportal.esploro.exlibrisgroup.com/esploro/outputs/journalArticle/Surveillance-of-pediatric-parapneumonic-effusionempyema-in/9926495172901891?institution=64OTAGO_INST

  Abstract Aim The incidence of childhood empyema has been increasing in some developed countries despite the introduction of pneumococcal vaccination. This study aimed to document the incidence, bacterial pathogens, and morbidity/mortality of parapneumonic effusion/empyema in New Zealand. […] Annual pediatric parapneumonic effusion/empyema incidence was 5.6/100,000 (95% confidence interval [CI]: 4.7–6.9). […] New Zealand has a high incidence of pediatric complicated parapneumonic effusion/empyema with significant morbidity.

• #42 Pleural empyema epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pleural_empyema_epidemiology_and_demographics

  The incidence and prevalence of empyema has been increasing over the past 15 years. More than 40% of patients have preexisting comorbidities. […] There have been a 26% increase in age and sex-standardized incidence rate from 8.7 per 100,000 person-years in 1997 to 11.8 per 100,000 person-years in 2011. This increment is most notably among older people aged 80 years (87.3% [from 20.4 per 100,000 in 1997 to 38.2 per 100,000 in 2011]) compared with people aged 40 to 64 years (27.8% [from 10.7 per 100,000 in 1997 to 12.6 per 100,000 in 2011]). […] Men are more commonly affected with empyema than women. The male to female ratio is approximately 1.7- to 3.1-fold higher in men than in women. […] The rate of patients with empyema requiring hospitalization appears to be increasing in western populations, however updated population-based data are scanty. The few available data on adult empyema have reported increases between 30% and 97% over the past 15 years in the United States and Canada. […] There is however a decreasing trend in the median days of hospital stay from 22 days 17 days.

• #43 Thoracic Empyema | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27359

  In the US, the incidence of parapneumonic empyema is estimated to be 6 cases per 100,000. In-hospital mortality in patients older than 65 is approximately 16.1%. […] Between 2005 and 2014, 150,469 patients aged 18 and older were admitted to US hospitals for pleural infections. The average age of these patients was 58.3 years; 68% of patients were men. White patients accounted for 79.3% of the admissions, and 4.4% of patients presented with either severe sepsis or septic shock.

• #44 Current status and prospect of medical and surgical management for thoracic empyema – Higuchi – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/37523/html

  Recent epidemiologic studies have indicated that the incidence of empyema has been increasing during the last few decades. In 2016 in Japan, 2,833 cases of empyema were reported and hospital mortality rate was 6.9%. In the United States, the estimated incidence of parapneumonic empyema is 6 cases per 100,000 people, and the hospital mortality rate in the adult population is approximately 16.1%. Risk factors of empyema include diabetes mellitus, gastroesophageal reflux, poor dental hygiene, chronic lung disease, alcohol abuse, and so on. Empyema may develop as a complication of pulmonary infection, thoracic and abdominal surgery, trauma, and iatrogenic procedures. However, pleural infection may also occur as a primary infection without pneumonia.

• #45 Thoracic Empyema | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27359

  In the US, the incidence of parapneumonic empyema is estimated to be 6 cases per 100,000. In-hospital mortality in patients older than 65 is approximately 16.1%. […] Between 2005 and 2014, 150,469 patients aged 18 and older were admitted to US hospitals for pleural infections. The average age of these patients was 58.3 years; 68% of patients were men. White patients accounted for 79.3% of the admissions, and 4.4% of patients presented with either severe sepsis or septic shock.

• #46

  https://mansapublishers.com/index.php/ijch/article/view/612?articlesBySameAuthorPage=26

  Empyema thoracic is known to have a variable age group affection, causative agents and controversy regarding primary mode of management. […] The aim of this study was to study the epidemiology, management strategies including investigations and outcome of empyema in the children. […] Among study population, male to female ratio was 1.48:1. […] Total 31.57% of the cultures were positive. […] There was a significant correlation between duration of illness (7 days) and advancement in the stage of empyema (p 0.0001). […] Overall outcome of empyema was excellent, mortality was less than 1.5%, with overwhelming sepsis. […] Staging of empyema at initiation of treatment helps in proper management of patients.

• #47 Epidemiology and prognostic factors of pleural empyema | Thorax

  https://bibliotheek.ehb.be:2672/content/76/11/1117

  Infection of the pleural cavity invariably leads to hospitalisation, and a fatal outcome is not uncommon. Our aim was to study the epidemiology of pleural empyema on a nationwide basis in the whole population and in three subgroups of patients, namely post-lung resection, associated cancer and those with no surgery and no cancer. […] There were 25512 hospitalisations for pleural empyema. The annual rate was 7.15 cases per 100000 habitants in 2013 and increased to 7.75 cases per 100000 inhabitants in 2017. […] Empyema is increasing in incidence. Factors associated with mortality are recent lung resection and associated diagnosis of cancer.

• #48 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  Rates of pleural empyema are increasing in English hospitals without any improvement in patient outcomes. This study also found that male predominance of empyema increased with age, and rates increased in winter and during peaks of influenza. […] Epidemiological studies have suggested that the incidence of pleural empyema is increasing. […] The link between viral influenza and secondary bacterial pneumonia has been demonstrated in epidemiological, observational and animal studies. The relationship between influenza and empyema is less well described, although it has a biological and epidemiological basis. […] This study assessed the changes in rates of pleural empyema in England over the past decade and possible association with influenza. Data from HES have shown a significant increase of empyema rates over the study period, as well as average seasonal increases in winter months of 25%.

• #49 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  This is the first epidemiological assessment of pleural empyema in England which has demonstrated that incidence is rising in the elderly. The male predominance of the condition increases with age for reasons that remain unclear. In addition, this is the first study to show the marked increase in empyema incidence in winter months which is temporally associated with influenza.

• #50 Management of parapneumonic pleural effusion in adults | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-manejo-del-derrame-pleural-paraneumonico-articulo-S1579212915003158

  Of the one million patients hospitalized annually in the United States for pneumonia, around 60,000 will present empyema, and a further 25,000 will develop it for other reasons. […] Despite clinical advances, the incidence of PI, irrespective of its stage of development, is increasing worldwide across all age groups. […] In the United States, the rate of hospitalization for empyema doubled from 1996 to 2008 (from 3.04 to 5.98/100,000 population), across all age groups. […] The incidence of PPE is increasing worldwide, across all age groups.

• #51 Epidemiology of pleural empyema in English hospitals and the impact of influenza

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8411895/

  This is the first epidemiological assessment of pleural empyema in England which has demonstrated that incidence is rising in the elderly. The male predominance of the condition increases with age for reasons that remain unclear. In addition, this is the first study to show the marked increase in empyema incidence in winter months which is temporally associated with influenza.

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