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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 29-April-2011, Vol 124 No 1333

[full text] [PDF]

Increased incidence of empyema in Polynesian children
Naomi Wright, Philip Hammond, Philip Morreau, James Hamill

Abstract


Aim
The aim of this study was to review the epidemiology, treatment and outcome of surgically managed empyema in children.

Method
A retrospective review was undertaken of all surgically managed empyema at Starship Children's Hospital (Auckland, New Zealand) from 1 July 2003 to 30 June 2008.

Results
Of the 93 children diagnosed with empyema, 62 were managed surgically (55 VATS, 7 thoracotomy) and 31 with tube thoracostomy alone. 71% were of Māori or Pacific ethnicity despite making up just 30% of the New Zealand paediatric population (p<0.0001). Median duration of chest drainage following VATS was 3 days and postoperative hospital stay 14 days. There was a 5% conversion of VATS to thoracotomy. The VATS complication rate was 16%: one intraoperative cardiorespiratory arrest following rupture of an intrapulmonary abscess into the bronchial tree, two contralateral empyema, one recurrent empyema, four air leaks and a wound infection.

Conclusion
For the first time increased incidence of empyema in the Polynesian population has been documented. Severity of empyema may be higher within the Polynesian population affecting treatment outcome.

     
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