Factors Associated with Open Thoracic Surgery in Children with Pleural Effusion: A Retrospective Observational Study
| Author | Farinaz Amirikar | en |
| Author | Nemat Bilan | en |
| Author | Amirmahmoud Erfani | en |
| Author | Saeid Aslanabadi | en |
| Author | Sajjad Pourasghary | en |
| Orcid | Farinaz Amirikar [0000-0001-9682-2946] | en |
| Orcid | Nemat Bilan [0000-0002-1849-4462] | en |
| Orcid | Amirmahmoud Erfani [0009-0003-1898-1855] | en |
| Orcid | Saeid Aslanabadi [0000-0002-0613-8794] | en |
| Orcid | Sajjad Pourasghary [0000-0002-1176-583X] | en |
| Accessioned Date | 2026-11-11T11:09:41Z | |
| Issued Date | 2026-11-30 | en |
| Abstract | Background: Pleural effusion may complicate pediatric respiratory disease and occasionally necessitate open thoracic surgery despite medical or minimally invasive management. Evidence regarding clinical and biochemical characteristics specifically associated with open thoracic surgery in children remains limited. Objectives: To identify demographic, clinical, imaging, laboratory, and preadmission medication factors associated with open thoracic surgery in hospitalized children with pleural effusion. Methods: This retrospective observational study included children older than 1 month and younger than 18 years who were treated for pleural effusion at Zahra Mardani Azari Children's Hospital, Tabriz, Iran, between March 2023 and March 2024. The primary outcome was open thoracic surgery, defined as thoracotomy with decortication, segmentectomy, or lobectomy. The comparison group included children managed without open thoracic surgery. Between-group comparisons and logistic regression were used to examine associations, which are reported as odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of the 83 children, 34 (41.0%) underwent open thoracic surgery and 49 (59.0%) did not. Severe imaging-assessed pleural effusion was more common in the open thoracic surgery group (55.9% vs. 28.6%; P = 0.024), and hospitalization was longer (19.1 ± 11.0 vs. 12.9 ± 5.3 days; P < 0.001). Pleural-fluid total protein and lactate dehydrogenase levels were higher, whereas glucose levels were lower, in the open thoracic surgery group (all P < 0.001). In the reported adjusted analyses, pleural-fluid total protein (adjusted OR 4.30 per 1 g/dL increase; 95% CI 1.90 - 9.60), glucose (aOR 0.32 per 10 mg/dL increase; 95% CI 0.19 - 0.54), ibuprofen exposure (aOR 3.39; 95% CI 1.09 - 10.52), and diclofenac exposure (aOR 4.41; 95% CI 1.12 - 17.33) were associated with open thoracic surgery. Conclusions: Pleural-fluid biochemical characteristics and preadmission nonsteroidal anti-inflammatory drug exposure were associated with open thoracic surgery in this retrospective cohort. These findings are exploratory, do not establish causation or clinical surgical thresholds, and should not be used as a stand-alone prediction rule. | en |
| DOI | https://doi.org/10.5812/jcp-174681 | en |
| URI | https://brieflands.com/journals/jcp/articles/174681 | en |
| Keyword | Pleural Effusion | en |
| Keyword | Child | en |
| Keyword | Thoracotomy | en |
| Keyword | Risk Factors | en |
| Keyword | Biomarkers | en |
| Keyword | Anti-Inflammatory Agents, Non-Steroidal | en |
| Publisher | Brieflands | en |
| Title | Factors Associated with Open Thoracic Surgery in Children with Pleural Effusion: A Retrospective Observational Study | en |
| Type | Research Article | en |
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