Factors Affecting Treatment Failure of Tuberculosis Empyema with Chest Tube Drainage at Persahabatan Hospital

· Lung Infection

Yovi I, Swidarmoko B, Burhan E. J Respir Indones. 2012;32(2):78-84.


Introduction: The therapy for tuberculosis empyema is more complicated compared to the therapy for non-tuberculosis empyema. Surgical treatment is frequently necessary. However, the optimum time at which surgical intervention must be performed is still not settled.
Methods: The medical records of patients with final diagnosis of thoracic tuberculosis empyema were collected during January 2004 to December 2008. A control group (success group with chest tube drainage) and a case group (failure group with chest tube drainage) were selected. Both groups were compared for factors that may influence the failure of chest tube drainage (case-control study).
Results: In five years, 61 cases of thoracic empyema were recorded. Out of 47 traceable cases of thoracic empyema, 74.5% were tuberculosis empyema. Most patients (85.7%) are male in 40-60 year age group. The most frequent complaints were dyspnea, coughs, fever, weight loss, sleep hyperhidrosis, chest pain and hemoptysis, as well as anaemia and hypoalbumin. In average, the patients experienced 22 days of dyspnea. BTA tests or culture of M. tuberculosis in pleural, sputum, or bronchial aspirate gave positive results in 45.7% cases while in 37.1% cases, diagnosis were based on clinical symptoms and imaging studies. Water-seal chest drainage is placed in all patients with 40% success rate. Decortications with 100% success rate were failed in all WSD cases. Fatality occurred in 8.6% of patients.
Conclusion: Chest pain and 40 mg/dL pleural glucose levels were the independent risk factors that affect the failure of chest tube drainage in tuberculosis empyema

Key words: tuberculosis empyema, chest tube drainage

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