A Retrospective Cohort Study Evaluating the Safety and Efficacy of Sequential versus Concurrent Intrapleural Instillation of Tissue Plasminogen Activator and DNase for Pleural Infection
Table 5
Comparison of patient characteristics, treatment, and outcomes between sequential and concurrent intrapleural therapy.
Sequential ()
Concurrent ()
value
Age (years)
64 (54-72)
64 (54-72)
0.871
Charlson’s comorbidity score
4 (2-6)
4 (2-6)
0.221
Hospital-acquired infection
13 (15.5)
6 (11.8)
0.548
RAPID score
3 (2-5)
3 (2-4)
0.615
Percentage of pleural opacity on CXR before intrapleural therapy
30.3 (13.4-52.3)
36.5 (26.5-51.4)
0.116
First dose of tPA/DNase given within 48 hours of chest drain insertion
43 (51.2)
36 (70.6)
0.027
Number of doses of tPA/DNase therapy given
4 (3-6)
3 (2-3)
<0.001
≤3 doses of intrapleural therapy
42 (50.0)
43 (84.3)
<0.001
Once-a-day dosing of tPA/DNase therapy
18 (21.4)
10 (19.6)
0.800
5 mg alteplase given as first dose or for all doses
13 (15.5)
2 (3.9)
0.038
Antiplatelet or anticoagulation therapy during tPA/DNase therapy
11 (13.1)
11 (21.6)
0.196
Platelet count (×109/L)
410 (309-527)
388 (313-527)
0.690
Prothrombin time (seconds)
11.3 (10.9-11.9)
11.4 (10.9-11.9)
0.833
Activated partial thromboplastin time (seconds)
31.9 (29.9-34.7)
31.3 (28.5-32.8)
0.109
Pleural fluid drained at 72 hours after intrapleural therapy
1430 (868-2095)
1637 (1135-1637)
0.090
Decrease in percentage of pleural effusion size (%)‡
15.1 (6.0-35.7)
26.6 (9.9-38.7)
0.143
Failed therapy or adverse events
22 (26.2)
13 (25.5)
0.928
Failed therapy
8 (9.5)
3 (5.9)
0.534
Required surgery for empyema
2 (2.4)
1 (2.0)
In-hospital mortality due to pleural infection
5 (6.0)
1 (2.0)
30-day readmission due to pleural infection
2 (2.4)
1 (2.0)
Pleural bleeding requiring blood transfusion
4 (4.8)
5 (9.8)
0.298
Pleural bleeding resolved after discontinuation of tPA/DNase therapy
3 (3.6)
4 (7.8)
Pleural bleeding requiring surgery
1 (1.2)
1 (2.0)
Chest pain requiring escalation of analgesia
11 (13.1)
5 (9.8)
0.566
Data are presented in number (percentage) and median (interquartile range) for categorical and continuous variables, respectively. CT: computed tomography; CXR: chest X-ray. Data missing for 4, 3, and 1 patient/s in the total, sequential, and concurrent therapy groups, respectively. ‡Data missing for 8, 7, and 1 patient/s in the total, sequential, and concurrent therapy groups, respectively.
