Clinical features, management and outcomes of pediatric pleural empyema: A retrospective, multicenter cross sectional study

Objectives: To evaluate clinical features, treatment strategies, and outcomes of pleural empyema for children who were treated at referral pediatric hospitals in 8 provinces of Iran.Methods: In this retrospective, multicenter cross sectional study, we retrospectively retrieved patients' data from 8 teaching hospitals during 2010 and 2017. A questionnaire was applied and filled, and all data were statistically and descriptively analyzed. Results: In total, 191 children (109 males and 82 females) were included. Their mean age was 4.95 years and ranged from 11 months to 16 years. The majority of cases (45.1％) were 1-4 years old. Fever (70.3％), cough (65.6％), tachypnea (53.1％), chest pain (14.6％), and abdominal pain (12％) were the most common manifestations at admission. The mean length of admission in hospital was 16.4 d. Consequently, 27 patients (14.1％) were admitted into the pediatric intensive unit because of severe illness, and 15 patients (7.9％) died. Logistic regression analysis showed that younger age (less than 12 months) and presence of underlying diseases (such as cardiovascular disease, immune deficiencies, malignancies, and neuro-developmental delay) significantly increased the mortality rate of patients with pleural empyema (P=0.004 and P=0.001, respectively). Conclusions: Pleural empyema children of younger age and with underlying diseases are at higher risks of death. In addition, guidelines for treating pleural empyema should be developed.