Abstract
Tuberculous empyema (TE) is associated with high mortality and morbidity. In the retrospective cohort study, we aimed to find risk factors for TE among pleural tuberculosis (TB) patients. Between July 2011 and September 2015, all culture-confirmed pleural TB patients (474 cases) were enrolled in our study. Empyema was defined as grossly purulent pleural fluid. Demographic and epidemiological data were collected for further analysis. Multivariate logistic regression analysis was used to evaluate risk factors of TE in pleural TB, age–adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated to show the risk. The mean age was 35.7 ± 18.1 years old, males comprised 79.1% of the participants (375 cases). Forty-seven patients (9.9%) were multidrug-resistant TB (MDR-TB), 29 (6.1%) had retreatment TB, 26 (5.5%) had diabetes mellitus. The percentage of empyema patients was 8.9% (42 cases). Multivariate analysis revealed that male (adjusted OR = 4.431, 95% CI: 1.411, 13.919), pleural adenosine deaminase (ADA, >88 U/L) (adjusted OR = 3.367, 95% CI: 1.533, 7.395) and white blood cell (WBC, >9.52 109/L) (adjusted OR = 5.763, 95% CI: 2.473, 13.431) were significant risk factors for empyema in pleural TB, while pulmonary TB (adjusted OR = 0.155, 95% CI: 0.072, 0.336) was the protective factor for the patients. TE remains a serious threat to public health in China. Male sex is a significant risk factor for TE while the presence of pulmonary TB is protective, and high levels of pleural ADA and WBC count could aid in early diagnosis of TE. This finding would help towards reducing the mortality and morbidity associated with TE.
Highlights
Www.nature.com/scientificreports diabetes mellitus, malignancies, immunosuppression, gastro-oesophageal reflux disease and alcohol and drug addiction, are found to increase the risk of progression to empyema[14]
The presence of empyema was associated with age (OR = 0.973, 95% confidence interval (CI): 0.951, 0.995), pulmonary TB (OR = 0.244, 95% CI: 0.127, 0.467), dyspnea (OR = 2.000, 95% CI: 1.025, 3.903), effusion site, pleural biochemical tests (glucose (OR = 0.802, 95% CI: 0.697, 0.922), lactate dehydrogenase (LDH) (OR = 1.000, 95% CI: 1.000, 1.000) and adenosine deaminase (ADA) (OR = 1.009, 95% CI: 1.004, 1.013)) and hematological tests (WBC (OR = 1.123, 95% CI: 1.025, 1.232), red blood cell (OR = 2.385, 95% CI: 1.332, 4.270), hemoglobin (OR = 1.023, 95% CI: 1.005, 1.041), hematocrit (OR = 1.098, 95% CI: 1.026, 1.176) and erythrocyte sedimentation rate (OR = 0.985, 95% CI: 0.972, 0.998))
Further multivariate analysis (Hosmer–Lemeshow goodness-of-fit test: χ2 = 2.329, df = 5, P = 0.802) revealed that male, pleural ADA (>88 U/L) and WBC (>9.52 109/L) were significant risk factors for empyema in pleural TB, while pulmonary TB was the protective factor for the patients (Table 3, Additional File 2)
Summary
In the retrospective cohort study, we aimed to find risk factors for TE among pleural tuberculosis (TB) patients. In the retrospective cohort study, we aimed to evaluate risk factors for TE among pleural TB patients
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