Khady Thiam*, Bouchra Elberhichi, Fatimata Binetou Rassoule Mbaye, Souleymane Diatta, Papa Masserigne Soumaré, Mbaye Fall, Marème Sangharé, Yacine Dia Kane, Philippe Astoul and Nafissatou Omar Touré
Introduction: Thoracic empyema, the presence of pus in the pleural cavity, is a severe disease that can be life-threatening.
Objective: To assess a newly defined severity scoring system of thoracic empyema in adults based on several predictive factors.
Methods: A retrospective chart review of consecutive adult patients presenting thoracic empyema was conducted from January 2021 to July 2024. Patients were categorized into a cohort depending on non-isolated germ (G), use of Indian hemp (I), diabetes mellitus (D), no respiratory physiotherapy (P), no pleural washing (L), single-dose antibiotic (S) and age >60 years. Multivariate analysis was performed using binary logistic regression. Adjusted Odds Ratios (ORs) with their 95% Confidence Intervals (CI) were calculated for each variable included in the final model.
Results: A severity score labeled 'GIDPLS-60 was built with each item assigned from a cohort of 388 consecutive patients according to criteria previously mentioned. The enrolled patients were predominantly male (n=252, 65.2%) with a mean age of 40.7 ±1 4.6 years. According to the "GIDPLS-60" score, the risk of complications was 3-5% for a score ≤ 1, 29-42% for a score of 2 or 3 and at least 99% for a score ≥ 4. The higher scores were correlated to co-morbidities, smoking behavior and use of Indian hemp, mono antibiotic therapy, no isolated germ, no pleural drainage and physiotherapy.
Conclusion: The management of empyema which must be timely and appropriate, can be guided by the initial assessment with a scoring system based on clinical and therapeutic factors adapted to the local context.
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