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Risk Factors for the Development of Pleural Empyema in Children

Lookup NU author(s): Dr Mohamed Elemraid, Dr Alasdair Blain, Professor Stephen Rushton, Dr David Spencer, Professor Andrew GenneryORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Pediatric pleural empyema has increased substantially over the past 20 years and reasons for this rise remain not fully explained. We investigated potential risk factors for the development of empyema in children by examining a cohort of patients with community-acquired pneumonia. Demographic, clinical, and socioeconomic characteristics, use of Ibuprofen prior to presentation and selected potential epidemiological risk factors were analyzed. Data were collected froma prospective etiological study of radiologically confirmed pneumonia in hospitalized children aged <= 16 years. One hundred sixty children were enrolled; 56% were male and 69% aged <5 years. Empyema complication developed in 40 (25%) children. Children with empyema were more frequently prescribed Ibuprofen prior to admission to hospital than those without (82% vs. 46.2%; OR 1.94, 97.5% credible interval 0.80-3.18). Bacterial infection was strongly associated with the development of empyema (OR 3.34, 97.5% credible interval 1.70-5.14). In contrast age, sex, maternal age, parental smoking, level of socioeconomic status, nursery attendance, asthma, household characteristics (bedrooms and number of occupants) were not significantly different between groups. In conclusion, children with pneumonia who developed empyema had more often received Ibuprofen prior to hospitalization and confirmed bacterial infection. We suggest a population-based study involving both primary and secondary care settings would help to investigate the role of Ibuprofen use in modulating the course of disease in children with pneumonia. (C) 2014 Wiley Periodicals, Inc.

Publication metadata

Author(s): Elemraid MA, Thomas MF, Blain AP, Rushton SP, Spencer DA, Gennery AR, Clark JE, North East England Pediat Resp

Publication type: Article

Publication status: Published

Journal: Pediatric Pulmonology

Year: 2015

Volume: 50

Issue: 7

Pages: 721-726

Print publication date: 01/07/2015

Online publication date: 01/04/2014

Acceptance date: 28/02/2014

Date deposited: 25/08/2015

ISSN (print): 8755-6863

ISSN (electronic): 1099-0496

Publisher: Wiley-Blackwell


DOI: 10.1002/ppul.23041


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