Seventy adult @entity1 with @entity4327 were treated at the University of Michigan Medical Center between 1978 and 1982. Twenty-two (31%) of the @entity3509 were associated with @entity55 , 23 (33%) occurred as @entity260 , and seven (10%) were iatrogenic. When used as the initial mode of drainage, repeat thoracentesis was successful in only four of 11 cases (36%). Similarly, closed tube thoracostomy, as initial treatment, was successful in only 14 of 40 cases (35%). Rib resection, however, provided cure or control in 10 of 11 @entity1 (91%) when employed as the first treatment method. Eight of 12 @entity1 (67%) with parapneumonic @entity3509 were treated successfully with closed tube thoracostomy, in contrast to only two of 17 @entity1 (12%) with @entity86 so treated. Eventual control or cure of @entity3509 was achieved in 57 @entity1 (81%), whereas 13 (19%) died (five from their @entity3509 and eight with @entity3509 as an active problem at the time of @entity204 ). All of the five @entity3509 -caused @entity204 occurred in @entity1 who underwent chest tube drainage as the most invasive treatment modality. The mortality rate for immunosuppressed @entity1 was 40% (four of 10 @entity1 ). This analysis of a large recent series of adult @entity3509 suggests that chest tube drainage is often inadequate and more aggressive management is likely to result in fewer treatment failures and fewer total procedures. Early rib resection, especially for @entity86 and those in immunocompromised @entity1 , is recommended.

Modern management of adult XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity3509 :: ('MESH:D004653', 'Disease') :: ['empyemas', 'empyema'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative empyemas'] @entity4327 :: ('MESH:D016724', 'Disease') :: ['thoracic empyema'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death', 'deaths']
@entity4327 :: (MESH:D016724,Disease) :: ['thoracic empyema']
