Table 4 Summary of baseline patient characteristics
Author, year | Surgery vs fibrinolysis (n) | Surgical technique | Fibrinolysis technique | Cohort demographics (surgery vs fibrinolysis) | Definition of treatment success |
|---|---|---|---|---|---|
Ahmed, 2016 | 43 vs 35 | Open | Agent(s): Streptokinase Dose: 250,000 units Dilution: 100 ml 0.9% NaCl Chest drain clamp time: 4 h Duration: Daily for up to 14 days | Age: 55.53 (8.82) vs 56.42 (8.21), p = 0.89 BMI: 25.8 (4.56) vs 24.8 (3.9), p = 0.29 Female %: 11.6 vs 17.1 COPD: NR Smoker: 16 vs 12, p = 0.79 Diabetes: 14 vs 9, p = 0.51 Positive pleural fluid culture: 39 vs 33, p = 0.69 | Fibrinolysis - Daily drainage < 50 ml or resolution of pleural collection on chest radiography Surgery - No air leak and daily drainage < 50 ml post complete decortication to obtain maximum lung expansion |
Dusemund, 2013 | 30 vs 48 | VATS ± Open | Agent(s): Urokinase Dose: 100,000 units Dilution: 100 ml 0.9% NaCl Chest drain clamp time: 4 h Duration: NR; repeated up to 5 times | Age: NR BMI: NR Female %: 42.3 vs 57.7 COPD: NR Smoker: 33 vs 16 Diabetes: 11 vs 2 Positive pleural fluid culture: 17 vs 31 | N/A |
Ershadi, 2022 | 28 vs 18 | VATS | Agent(s): Streptokinase Dose: 250,000 units Dilution: 100 ml 0.9% NaCl Chest drain clamp time: 4 h Duration: 4 consecutive days | Age: 45.6 (10.6) vs 47.1 (11.3), p = 0.666 BMI: NR Female %: 21.4 vs 22.2, p = 0.949 COPD: 2 vs 1 Smoker: NR Diabetes: 4 vs 3 Positive pleural fluid culture: 13 vs 9 | - Sufficient pulmonary expansion thus not requiring decortication via thoracotomy |
Federici, 2021 | 66 vs 93 | VATS | Agent(s): Urokinase (until 2016)→ tPA + DNase Dose: 250,000 units→ 10 + 5 mg Dilution: 30 ml 0.9% NaCl Chest drain clamp time: 3 h Duration: BD for 5 days→BD for 5 days | Age: 56 [16] vs 62 [17], p = 0.048 BMI: Female %: 30.3 vs 31.2, p = 0.906 COPD: 8 vs 7, p = 0.705 Smoker: NR Diabetes: 6 vs 14 p = 0.057 Positive pleural fluid culture: 28 vs 24 | - Daily drainage < 200 ml - Cessation of air-leak - Resolution of infection / sepsis - Resolution of pleural loculations |
Kermenli, 2021 | 28 vs 21 | VATS | Agent(s): Alteplase Dose: 10 mg Dilution: 100 ml 0.9% NaCl Chest drain clamp time: 1 h Duration: BD; treatment duration not specified | Age: Combined: 50.6 (17.8), p = 0.294 BMI: NR Female %: NR separately COPD: 5 vs 1 Smoker: NR Diabetes: 4 vs 4 Positive pleural fluid culture: 5 vs 6 | - Lung expansion - Cessation of air-leak - Serous drain output - Daily drainage < 200 ml |
Metin, 2010 | 44 vs 23 | VATS | Agent(s): Streptokinase Dose: 250,000 units Dilution: 250 ml 0.9% NaCl Chest drain clamp time: 4–6 h Duration: Daily, until drainage < 100 ml/24 h and serous | Age: 49 [15] vs 55 [16] BMI: NR Female %: 40.9 vs 26.1 COPD: NR Smoker: NR Diabetes: NR Positive pleural fluid culture: 31 vs 13 | - Daily drainage < 100 ml - Serous drain output - > 50% pleural fluid drainage - Adequate lung expansion - Control of sepsis |
Muhammad, 2012 | 49 vs 20 | VATS and Open | Agent(s): Streptokinase Dose: 250,000 units Dilution: 100 ml 0.9% NaCl Chest drain clamp time: 4 h Duration: Daily for 7 days or until < 100 ml/24 h | Age: 32.0 (8.86) vs 32.3 (9.62) BMI: NR Female %: 25.49 vs 25 COPD: NR Smoker: NR Diabetes: NR Positive pleural fluid culture: NR | Fibrinolysis - Daily drainage < 100 ml - Radiologic resolution of pleural collection Surgery - Complete lung re-expansion (lungs touching lateral wall and diaphragm) - Cessation of air leak - Daily drainage < 100 ml |
Samancilar, 2018 | 54 vs 24 | VATS | Agent(s): Streptokinase Dose: 250,000 units Dilution: NR Chest drain clamp time: NR Duration: Daily for 5 days | Age: 44.48 (16.77) vs 45.75 (13.17), p = 0.744 BMI: NR Female %: 24.07 vs 20.83, p = 0.754 COPD: 10 vs 5 Smoker: NR Diabetes: 5 vs 0 Positive pleural fluid culture: NR | N/A |
Suarez, 2012 | 29 vs 84 | VATS ± Open | Agent(s): Urokinase Dose: 100,000 units Dilution: NR Chest drain clamp time: NR Duration: TDS for 48 h | Age: 53.2 (13.4) vs 51.7 (12.5) BMI: NR Female %: 24.1 VS 20.2 COPD: 7 vs 12 Smoker: 16 vs 45 Diabetes: 3 vs 14 Positive pleural fluid culture: NR | N/A |
Wilshire, 2023 | 10 vs 10 | VATS | Agent(s): tPA and DNase Dose: 10 mg and 5 mg Dilution: NR Chest drain clamp time: 1 h Duration: BD for total of 4 to 6 doses | Age: 59.2 (17.2) vs 52.4 (18.1) BMI: 27 [24–29] vs 24 [22–33] Female %: 20 vs 30 COPD: 1 vs 1 Smoker: NR Diabetes: 1 vs 1 Positive pleural fluid culture: 7 vs 4 | - Resolution of infection (fever, leucocytosis and persistent pleural collection > 48 h post intervention) |