Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study

BMC Pulmonary Medicine

Research

Hiroki Matsui¹  Tatsuya Nagai²  Ayumu Otsuki²  Jumpei Taniguchi²  Kei Nakashima²  Hiroyuki Ito²  Hiroshi Sugimura³ 

[1] Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;Clinical Research Support Office, Kameda Medical Center, Chiba, Japan;Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, 296- 8602, Kamogawa, Chiba, Japan;Department of Thoracic Surgery, Kameda Medical Center, Chiba, Japan;

关键词: Drainage;    Empyema;    Retrospective study;    Pleural infection;    Urokinase;   

DOI  :  10.1186/s12890-023-02559-5

 received in 2023-05-21, accepted in 2023-07-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection.MethodsIn this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery.ResultsAmong the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003).ConclusionsUrokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection.Trial registrationThe participants were retrospectively registered.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 7

Fig. 5