Early drainage reduces the length of hospital stay in patients with lung abscess

Po-Chang Chiang; Chia-Ying Lin; Ya-Chun Hsu; Li-Ting Huang; Ta-Jung Chung; Yi-Sheng Liu; Chao-Chun Chang

doi:10.3389/fmed.2023.1206419

Early drainage reduces the length of hospital stay in patients with lung abscess

Front Med (Lausanne). 2023 Sep 5:10:1206419. doi: 10.3389/fmed.2023.1206419. eCollection 2023.

Authors

Po-Chang Chiang¹, Chia-Ying Lin¹, Ya-Chun Hsu¹, Li-Ting Huang¹, Ta-Jung Chung¹, Yi-Sheng Liu¹, Chao-Chun Chang²

Affiliations

¹ Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Surgery, Division of Thoracic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Background: Although percutaneous transthoracic catheter drainage (PCD) has been proven effective in lung abscesses, the optimal timing of PCD is still unclear. The study aimed to evaluate the safety and efficacy of early versus delayed drainage in patients with lung abscesses.

Methods: This retrospective study included 103 consecutive patients with liquefied lung abscesses more than 3 cm confirmed by a CT scan received CT-guided PCD over 16 years, from July 2005 to September 2021, in a single institution were reviewed. Early drainage was defined as PCD within one week after a lung abscess was diagnosed. The primary outcome was 90-day mortality. The secondary outcomes included perioperative complications and patients' length of hospital stay (LoS). Factors associated with 90-day mortality and LoS were also analyzed. The key statistical methods were Chi-square test, Fisher's exact test, Student t-test, and Pearson correlation.

Results: Amount the 103 patients, there were 64 patients who received early PCD, and 39 patients received delayed PCD. Between the two groups, there were no significant differences in clinical characteristics, 90-day mortality, or perioperative complications. The LoS was significantly shortened in early PCD group (28.6 ± 25.5 vs. 39.3 ± 26.8 (days), p = 0.045). Higher Charlson comorbidity index, secondary lung abscess, and liver cirrhosis were associated with higher mortality (all p < 0.05). Positive sputum culture significantly increased the LoS (coefficient 19.35 (10.19, 28.50), p < 0.001).

Conclusion: The 90-day mortality and complications were similar for early PCD and delayed PCD patients, but LoS was significantly shortened in early PCD patient.

Keywords: drainage; interventional radiology (IR); length of stay; lung abscess; treatment outcome.