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Objective <p>To evaluate the association between the preoperative empyema space rate (ESR), a quantitative measure of empyema volume calculated based on three-dimensional computed tomography, and postoperative outcomes in patients undergoing video-assisted thoracic surgery for acute empyema.</p> Methods <p>This retrospective study included 118 patients at two centers (2015–2024). ESR was defined as the ratio of empyema space volume to total pleural space volume. Postoperative respiratory complications (Clavien-Dindo ≥ IIIa) and drainage duration were analyzed using logistic regression and Cox proportional-hazards regression, respectively. The clinical utility of the ESR was assessed by comparing the area under the curve (AUC) and concordance index (C-index) between a baseline model of established risk factors and the model with ESR added.</p> Results <p>Complications occurred in 25 patients (21.2%), including seven deaths. No variables, including ESR, emerged as independent risk factors for complications. However, adding ESR to the baseline model demonstrated a higher AUC for complications (0.705 vs. 0.686) and a higher C-index for drainage duration (0.645 vs. 0.634) compared to the baseline model using existing risk factors alone. Multivariable Cox proportional hazards analysis revealed that a higher ESR was independently associated with a lower probability of early chest tube removal (Hazard Ratio per 1% increase in ESR: 0.989, 95%CI 0.980–0.994).</p> Conclusions <p>The preoperative empyema space rate was not a significant predictor of postoperative respiratory complications but was an independent predictor of prolonged postoperative drainage duration.</p>

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Empyema space rate: a quantitative predictor of postoperative drainage duration after surgery for acute empyema

  • 期刊论文

  • 发表日期：

    2026年4月7日

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  • Yo Tsukamoto,
  • Takeo Nakada,
  • Saki Tsubouchi,
  • Yuto Watanabe,
  • Yu Suyama,
  • Satoshi Arakawa,
  • Takamasa Shibazaki,
  • Tomonari Kinoshita,
  • Shohei Mori,
  • Takashi Ohtsuka

摘要

Objective

To evaluate the association between the preoperative empyema space rate (ESR), a quantitative measure of empyema volume calculated based on three-dimensional computed tomography, and postoperative outcomes in patients undergoing video-assisted thoracic surgery for acute empyema.

Methods

This retrospective study included 118 patients at two centers (2015–2024). ESR was defined as the ratio of empyema space volume to total pleural space volume. Postoperative respiratory complications (Clavien-Dindo ≥ IIIa) and drainage duration were analyzed using logistic regression and Cox proportional-hazards regression, respectively. The clinical utility of the ESR was assessed by comparing the area under the curve (AUC) and concordance index (C-index) between a baseline model of established risk factors and the model with ESR added.

Results

Complications occurred in 25 patients (21.2%), including seven deaths. No variables, including ESR, emerged as independent risk factors for complications. However, adding ESR to the baseline model demonstrated a higher AUC for complications (0.705 vs. 0.686) and a higher C-index for drainage duration (0.645 vs. 0.634) compared to the baseline model using existing risk factors alone. Multivariable Cox proportional hazards analysis revealed that a higher ESR was independently associated with a lower probability of early chest tube removal (Hazard Ratio per 1% increase in ESR: 0.989, 95%CI 0.980–0.994).

Conclusions

The preoperative empyema space rate was not a significant predictor of postoperative respiratory complications but was an independent predictor of prolonged postoperative drainage duration.