Analysis Of Risk Factors For Fungal Empyema Thoracis In Adult' Patients

ObjectiveTo analyze the epidemiological data of empyema thoracis and analysis the risk factors of fungal empyema thoracis in adult patients,in order to provide theoretical guidance for rational preventions and effective therapies of fungal empyema thoracis.MethodsA single-center,retrospective study to analyze the risk factors for adult fungal empyema thoracis patients in the First Affiliated Hospital of Soochow University.The medical records of all patients diagnosed with empyema thoracis between January 2007 to December 2017 were reviewed.Those patients were divided into fungal infection group and non-fungal infection group according to the pathogenic bacteria.STATA 15.0 statistical software was used for data processing.Exploring risk factors of fungal empyema thoracis by means of single factor analysis and multiple factors Logistic regression analysis.ResultsA total of 194 adult empyema thoracis patients were confirmed from 202 cases with cultural-positive pleural effusion by excluding 8 cases of suspected contaminated specimen or catheter colonization during the eleven years.73.7%(143 cases)of them were men and their median age was 62.48 years old.30(15.4%)patients with fungal empyema thoracis were included,including 19 Candida albicans(55.9%).Diabetes,ACCI(Age-Adjusted Charlson's Comorbidity Index)above 4 points,non-surgical related upper gastrointestinal damage(including esophageal rupture and gastroduodenal perforation)and red blood cell count decrease could increase the risk of fungal empyema thoracis through single factor analysis(P<0.05).Multivariate Logistic regression analysis showed diabetes,non-surgical upper gastrointestinal damage and red blood cell count decrease were independent risk factors or predict indicator of fungal empyema thoracis.Conclusions1.Although fungal empyema thoracis was rare(15.4%)among empyema thoracis,it was serious with higher mortality(33.3%).2.Diabetes,non-surgical upper gastrointestinal damage and red blood cell count decrease were independent risk factors or predict indicator of fungal empyema thoracis.