Chest
Original ResearchDisorders of the PleuraSurvival in Patients With Malignant Pleural Effusions Who Developed Pleural Infection
Section snippets
Materials and Methods
All IPCs inserted for MPE between January 1, 2005, and January 31, 2014, in six UK centers were reviewed and cases of pleural infection identified. Recruitment periods differed between centers according to when services were established. Details are shown in e-Table 1. Pleural infection was defined as clinical symptoms and signs consistent with pleural infection, necessitating antibiotic treatment, with or without positive pleural fluid microscopy or culture. Superficial wound infections at IPC
Results
Six hundred seventy-two IPCs were inserted during the study period. Twenty-five patients (3.7%) were identified as having experienced pleural infection. Each patient had a single episode of pleural infection, affecting a unilateral IPC. One individual with pleural infection also appeared in the LENT cohort. This patient was removed from the LENT group prior to analysis. Baseline characteristics of patients with pleural infection are summarized in Table 1, and a patient flow diagram is shown in
Discussion
This retrospective review of practice from six UK hospitals suggests that patients who develop pleural infection with an IPC in situ for MPE may live longer than those without infection. Hazard modeling in this small sample did not achieve significance (P = .07); however, the trend toward significance, the appearance of the Kaplan-Meier survival curves, and the CIs that do not overlap (for the overall population and mesothelioma) raise the possibility of a genuine effect. Further research in
Conclusions
In summary, this review of 25 cases of pleural infection in patients with IPC for MPE suggests enhanced survival, particularly in patients with mesothelioma. Similarities between our population and previously published series indicate that this cohort is representative and support the possibility that this observation represents a genuine effect. The study has limitations, and statistical significance is not achieved; however, despite this, the Kaplan-Meier survival curves suggest a possible
Acknowledgments
Author contributions: A. C. B. and N. A. M. are the guarantors of the article and take responsibility for the manuscript, the data, and the analysis. A. C. B. and N. A. M. contributed to conceiving the article, collated and analyzed the data, and wrote the manuscript; A. O. C. contributed to providing data from the LENT cohort and contributed significantly to data analysis and manuscript writing; G. C. S., A. J. M., J. F., I. P., J. C. T. P., M. G. S., A. E. S., and N. M. R. contributed to
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This research was presented in abstract form (S117) at the British Thoracic Society Winter Meeting, December 5, 2014, London, England.
FUNDING/SUPPORT: The authors have reported to that no funding was received for this study.
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