title: Factors predictive of the failure of medical treatment in patients with pleural infection.
abstract: OBJECTIVE
  The clinical outcomes of some patients with pleural infection may be favorable with medical treatment alone, but in others, the disease progresses and requires additional surgical treatment. However, little is known about the factors affecting this difference. The aim of this study was to investigate the factors predictive of failure of medical treatment in patients with pleural infection.
  
  
  METHODS
  A cohort of 127 consecutive patients who were admitted to the hospital with pleural infection was studied. Clinical manifestations and laboratory findings in patients in whom medical treatment succeeded or failed were reviewed.
  
  
  RESULTS
  In univariate analysis, the significant factors associated with medical treatment outcome were age, smoking history, duration of chief complaint, serum albumin level, and pleural fluid glucose and lactate dehydrogenase levels (p < 0.05). Multivariate logistic regression analysis identified age and duration of chief complaint as independent predictive factors for failure of medical treatment, with odds ratios of 0.871 (p = 0.013) and 0.797 (p = 0.026), respectively. Receiver operating characteristic curve analysis determined cutoff values of 50.5 years for age and 4.5 days for duration of chief complaint.
  
  
  CONCLUSIONS
  We demonstrated that a younger age < 50.5 years and shorter duration of chief complaint < 4.5 days were independent predictive factors for the failure of medical treatment in patients with pleural infection. This suggests their role as evaluative criteria in setting indications for the optimal treatment in patients with pleural infection. A larger, prospective study is required to confirm these findings.
authors.affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Sung-Kyoung
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Chul Ung
authors.initials: CU
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: So Hyang
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Deog Gon
authors.initials: DG
authors.lastname: Cho
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Kyu Do
authors.initials: KD
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Chi Hong
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004322:Drainage; D016724:Empyema, Pleural / Q000378:metabolism / Q000628:therapy*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008297:Male; D010996:Pleural Effusion / Q000378:metabolism / Q000628:therapy*; D012709:Serum Albumin / Q000378:metabolism; D020775:Thoracic Surgery, Video-Assisted; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D012709:Serum Albumin; D007770:L-Lactate Dehydrogenase; D005947:Glucose
keywords: Drainage; Empyema, pleural; Fibrinolytic agents; Treatment outcome