Pneumonia can be associated with fluid in the chest – this is called parapneumonic effusion. The fluid can be simple and not infected (simple parapneumonic effusion) or can progress to become infected with bacteria (pleural infection). We know that patients with pleural infection are more likely to die or stay in hospital for a long time, but we are not sure about the effects of simple parapneumonic effusion on patient health and time in hospital.
There is some evidence suggesting that simple parapneumonic effusions may lead to poorer outcomes than pneumonia alone. However, there is little information on whether simple effusions should be treated. We hope to find out if early detection, monitoring, and treatment of simple parapneumonic effusions improve outcomes. To do this, we would like to use existing data to see if having pneumonia with a pleural effusion is associated with worse outcomes than just having pneumonia alone.
We will identify patients admitted with pneumonia and divide them into those with and without associated parapneumonic effusion. We will then look at all the effusion patients and identify which were “infected” and which were “not infected”. We will then compare these three groups of patients (i.e. pneumonia only, “not infected” effusion and “infected” effusions) in terms of:
- how long they stay in the hospital;
- if they die during their stay or within 30 days;
- if they need critical care or a ventilator;
- if they need a drain inserted in the chest to remove the fluid;
- if they need surgery;
- if their treatment works;
- if they need to be admitted again after discharge within 30 days.
Study findings will be used to support future work on predicting the development of parapneumonic effusion and using ultrasound to monitor and improve outcomes.