Assessment of the burden of paediatric empyema in Australia
- 31 July 2009
- journal article
- Published by Wiley in Journal of Paediatrics and Child Health
- Vol. 45 (7-8), 431-436
- https://doi.org/10.1111/j.1440-1754.2009.01533.x
Abstract
Aims: To investigate the change in incidence of childhood empyema and pneumonia in Australia, and ascertain the management trends in all hospitals caring for children with empyema. Methods: The incidences of empyema and pneumonia were calculated for each year between 1993/1994 and 2004/2005 using retrospective primary diagnostic coding from ICD‐9 and 10 comprising the Australian National Hospital Morbidity Database for five age groups in patients less than 20 years of age. Hospitals with allocated paediatric beds were surveyed on referral pattern and treatment preferences. Results: In this study, 145 562 patients with pneumonia were admitted with a mean (range) incidence of 2306 (1846–2652) per million. The trend towards an overall increase was not statistically significant. Only the 1–4 years old age group demonstrated a significant increase (P < 0.01, r2= 0.61). A total of 469 cases of empyema were identified with a mean incidence of 7.35 (4–10.2) per million. There was an overall increase in incidence (P < 0.05, r2= 0.51) reflecting an increase in the 1‐ to 4‐year‐olds (P < 0.005, r2= 0.60) and 15‐ to 19‐year‐olds (P < 0.05, r2= 0.37). The overall percentage of empyema as a proportion of pneumonia increased from 0.27 to 0.70% (0.48% (0.27–0.70%), P < 0.05, r2= 0.38). The survey response rate was 75%. Ninety‐nine of 121 (82%) hospitals referred children with empyema to a more appropriate centre with wide variations in treatments provided. Conclusions: The rise in incidence of empyema reflects that seen in other countries. Furthermore, there are diverse management practices suggesting a clear need for national guidelines.This publication has 27 references indexed in Scilit:
- Invasive Pneumococcal Disease Caused by Nonvaccine Serotypes Among Alaska Native Children With High Levels of 7-Valent Pneumococcal Conjugate Vaccine CoverageJAMA, 2007
- CHILDHOOD EMPYEMA: LIMITED POTENTIAL IMPACT OF 7-VALENT PNEUMOCOCCAL CONJUGATE VACCINEThe Pediatric Infectious Disease Journal, 2006
- Impact of the Pneumococcal Conjugate Vaccine on Pneumococcal Parapneumonic EmpyemaThe Pediatric Infectious Disease Journal, 2006
- Increasing paediatric empyema admissionsThorax, 2006
- Management of empyema in childrenPediatric Pulmonology, 2005
- Clinical features, aetiology and outcome of empyema in children in the north east of EnglandThorax, 2004
- An Epidemiological Investigation of a Sustained High Rate of Pediatric Parapneumonic Empyema: Risk Factors and Microbiological AssociationsClinical Infectious Diseases, 2002
- Increase in incidence of childhood empyema in West Midlands, UKThe Lancet, 1997
- Pneumococcal Pleural Empyemas in ChildrenClinical Infectious Diseases, 1996
- Empyema in children: A twenty-five-year studyThe Journal of Pediatrics, 1958