Outcome of management of thoracic empyema: a retrospective cohort study at Kinshasa University Hospital, Democratic Republic of Congo

Abstract

Context and objective. Pleural empyema is an infection defined by the collection of pus in the pleural cavity and is associated with a significant mortality. The objective of the present study was to compare the outcome of pleural decortication and of pleural drainage. Methods. Retrospective and analytical longitudinal follow up study conducted in the Thoracic Surgery Department of the Kinshasa University Hospital from January 2000 to June 2024. Patients were divided into two groups: group A for patients treated by pleural decortication and group B for those who benefited from pleural drainage. Results. Data from 60 patients were collected: 9 (15%) in group A and 51 (85%) in group B. Dyspnea (68, 6%) was more frequent in group B. Pus culture was positive in 17 patients (11 in group B vs. 6 in group A, p=0,006). The most common germs were Klebsiella pneumoniae and Pseudomonas aeruginosa. Mycobacterium tuberculosis was found in 2 patients in group A (p=0,001). The mean length of hospital stay was significantly greater in group A (91,8±70,6 days versus 35,86±27,8 days, p=0,045). The median survival of patients was better in the same group (37 versus 35 days). Overall, in-hospital mortality was 30 %, with no significant difference between patients in the 2 groups. Conclusion. Pleural empyema is a frequent and serious pathology, with a high mortality rate. Pleural decortication improves patient survival. Early surgical management is recommended.

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Received: February 28^th, 2025

Accepted: June 17^th, 2025

https://dx.doi.org/10.4314/aamed.v18i4.12