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 Vol. 20 No. 4, October 2008
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AAP Grand Rounds 20:42-43 (2008)
© 2008 American Academy of Pediatrics

CRITICAL CARE

Early Thoracoscopy Leads to Shorter Length of Stay for Pneumonia Complicated by Pleural Effusion

Source: Shah SS, DiCristina CM, Bell LM, et al. Primary early thoracoscopy and reduction in hospital length of stay and additional procedures among children with complicated pneumonia: results of a multicenter retrospective cohort study. Arch Pediatr Adolesc Med. 2008:162(7);675–681; doi:10.1001/archpedi.162.7.675[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: Among children requiring early surgical intervention for complicated pneumonia, is early video-assisted thoracoscopic surgery associated with better outcomes than other interventions?

Question type: Intervention

Study design: Retrospective cohort

 

To determine the effect of initial procedure type on the hospital length of stay (LOS) and on the requirement for additional pleural fluid drainage procedures in children with pneumonia-related pleural effusion (complicated pneumonia) undergoing early pleural fluid drainage, authors from the Children’s Hospital of Philadelphia and the University of Pennsylvania retrospectively reviewed the records of all children between 12 months and 18 years of age treated for complicated pneumonia at children’s hospitals participating in the Pediatric Health Information System (PHIS) from 2001 through 2005.

PHIS is an administrative database that during the study period contained inpatient data from 42 not-for-profit freestanding pediatric hospitals in the US. Early interventions were those that occurred within 48 hours of hospitalization and included a thoracoscopic tube placement, video-assisted thoracoscopic surgery (VATS), or primary thoracotomy.

There were 2,862 cases of complicated pneumonia among 49,574 patients treated for pneumonia (5.8%). A pleural drainage procedure was performed in 961 cases within 48 hours of admission (33.6%). Among these 961 children, the median . . . [Full Text of this Article]

Luke Zabrocki, MD, FAAP
Critical Care Medicine and Pediatrics, University of Utah School of Medicine, Salt Lake City, UT