Surgical Decortication outcome and Associated factors among Adult Patients with Empyema Thoracis at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2015 E.C

Abstract

Abstract Background: Empyema thoracis is a prevalent health issue with a rising incidence observed in recent studies. The causes of empyema vary significantly depending on geographic location and economic status. In developed countries, trauma is the primary cause, whereas infectious causes, particularly tuberculosis, rank highest in developing nations. Surgical decortication, whether performed through video-assisted thoracoscopy or open surgery, remains the primary treatment method, for stage II-III pleural empyema as classified by the American Thoracic Society. Objectives: to assess the outcome of surgical decortication and associated factors among patients with empyema thoracis at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia, From May 1, 2010 to April 30, 2015 E.C. Methods: Hospital based cross-sectional study was carried at St, Paul hospital, Addis Ababa, Ethiopia. 5-year retrospective review of all complete records of patients who were operated included. And also, binomial logistic regression was done to determine factors associated with treatment outcome considering a significance level of 0.05 Results: a total of 53 patients were included in the study of which male to female ratio was 3.4:1 and mean age was 38 +_ 13.8yr. Average duration of symptoms before visiting our hospital was 4.45+_ 5.27 months and total hospital stay was 15+_ 11.29 days and cough (86.8%), fever (75.5%) and weight loss as well as shortness of breath were leading complaints to visit health care facility. Majority of the patients were diagnosed as stage III empyema and open thoracotomy and abscess drainage being the most common procedure done. Over all complications encountered intraoperatively accounts to 26.4%, bleeding being the most common one. During follow up month 95.2 % of patients showed both clinical and radiologic improvements and returned to their daily activities and there was no death. Conclusion and recommendation: in general, based on our experiences, out come after decortication for empyema was favorable. Majority of patients returned to their base line functions and got improved clinically and radiologically. So, we encourage early decortication and abscess drainage in patients with empyema which increases morbidity and mortality . Keywords: Empyema Thoracis, Hospital Stay, Treatment Outcome, Surgical Decortication