title: Pleural Empyema and Aortic Aneurysm: A Retrospective National Population-Based Cohort Study.
abstract: Pleural empyema (PE) may evolve into necrosis, fistula in the thorax, and sepsis; thus, it is also associated with high mortality.We investigated and analyzed the risk of aortic aneurysm (AA) in a cohort study of patients with PE.A total of 34,250 patients diagnosed with PE were identified as the PE cohort, and 137,000 patients without PE were selected randomly as the control group and matched by sex, age, and index year of PE diagnosis. Patients ages 20 years and younger with a history of AA were excluded. The risk of AA was analyzed using a Cox proportional hazards regression model.Excess risk of AA development was 1.69-fold higher in PE patients (adjusted hazard ratio [aHR] = 1.69; 95% confidence interval [CI] = 1.39-2.05) compared with non-PE patients. The patients with PE exhibited a greater adjusted risk of AA (aHR = 2.01; CI = 1.44-2.81) even if they did not have any of the 9 comorbidities included in our analysis (diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, heart failure, cardiac artery disease, stroke, bacterial endocarditis, and rheumatic endocarditis). Compared with the patients without any of the 9 comorbidities or PE, the patients with only PE had a greater risk of developing AA (aHR = 2.00; CI = 1.43-2.79). The PE cohort had a significantly higher cumulative incidence of AA than the non-PE cohort did during 12 years of follow-up.In a large-scale cohort, patients with PE are linked with an increased risk of AA.
authors.affiliation: From the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (C-YW, T-WS, P-JK, S-YY, T-CK); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University (K-YH, T-CS); Department of Physical Medicine and Rehabilitation, China Medical University Hospital and China Medical University (T-YC), Management Office for Health Data (C-LL), and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital; College of Medicine (C-LL) and Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (C-HK), China Medical University, Taichung, Taiwan.
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Wu
authors.forename: Ta-Wei
authors.initials: TW
authors.lastname: Su
authors.forename: Kuo-Yang
authors.initials: KY
authors.lastname: Huang
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.forename: Sheng-Yueh
authors.initials: SY
authors.lastname: Yu
authors.forename: Tsung-Chi
authors.initials: TC
authors.lastname: Kao
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Shen
authors.forename: Tzu-Yi
authors.initials: TY
authors.lastname: Chou
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000453:epidemiology*; D015897:Comorbidity; D016724:Empyema, Pleural / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology