Sonographic septation: A useful prognostic indicator of acute thoracic empyema

The aim of this study was to identify sonographic predictors of patient out comes or need for surgical intervention df acute thoracic empyema. All pati ents with a clinical diagnosis of thoracic empyema underwent transthoracic ultrasonographic examination and thoracentesis at admission. According to t he presence or absence of septa in sonographic images, the patients were cl assified into two groups: septated and nonseptated. Sonographic findings we re analyzed with respect to duration of hospital stay, chest tube drainage, and treatment efficacy. A total of 163 consecutive the study (83 patients with patients were included in septated and 80 with nonseptated sonographic images). The mean duration of hospital stay (35.4 versus 27.0 days, P = 0. 009) and chest tube drainage (13.1 versus 7.6 days, P < 0.001) for the pati ents with septa were significantly longer than for those without septa. The patients with septa were more likely to undergo intrapleural fibrinolytic therapy (63.8% versus 38.8%, odds ratio 2.79, P = 0.001) and surgical inter vention (24.3% versus 7.5%, odds ratio 3.92, P = 0.004). We concluded that sonographic septation is a useful sign to predict the need for subsequent i ntrapleural fibrinolytic therapy and surgical intervention in cases of acut e thoracic empyema. Early fibrinolytic therapy or even surgical interventio n may be indicated in patients with sonographic septations.