title: Increased incidence of empyema in Polynesian children.
abstract: OBJECTIVE
  The aim of this study was to review the epidemiology, treatment and outcome of surgically managed empyema in children.
  
  
  METHODS
  A retrospective review was undertaken of all surgically managed empyema at Starship Children's Hospital (Auckland, New Zealand) from 1 July 2003 to 30 June 2008.
  
  
  RESULTS
  Of the 93 children diagnosed with empyema, 62 were managed surgically (55 VATS, 7 thoracotomy) and 31 with tube thoracostomy alone. 71% were of Maori or Pacific ethnicity despite making up just 30% of the New Zealand paediatric population (p<0.0001). Median duration of chest drainage following VATS was 3 days and postoperative hospital stay 14 days. There was a 5% conversion of VATS to thoracotomy. The VATS complication rate was 16%: one intraoperative cardiorespiratory arrest following rupture of an intrapulmonary abscess into the bronchial tree, two contralateral empyema, one recurrent empyema, four air leaks and a wound infection.
  
  
  CONCLUSIONS
  For the first time increased incidence of empyema in the Polynesian population has been documented. Severity of empyema may be higher within the Polynesian population affecting treatment outcome.
authors.affiliation: Department of Surgery, University College Hospital, London, UK. naomiwright@doctors.org.uk
authors.forename: Naomi
authors.initials: N
authors.lastname: Wright
authors.forename: Philip
authors.initials: P
authors.lastname: Hammond
authors.forename: Philip
authors.initials: P
authors.lastname: Morreau
authors.forename: James
authors.initials: J
authors.lastname: Hamill
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002669:Child Welfare / Q000706:statistics & numerical data; D016724:Empyema, Pleural / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020775:Thoracic Surgery, Video-Assisted / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data; D000095188:Pacific Island People / Q000706:statistics & numerical data; D009520:New Zealand / Q000453:epidemiology / Q000208:ethnology
chemical_list: D000900:Anti-Bacterial Agents