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Hold Those Scalpels—Reply
Su-Ting T. Li, MD, MPH;
Robert L. Gates, MD
Arch Pediatr Adolesc Med. 2008;162(7):698-699.
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In reply
We appreciate Weinstein and Cohen's thoughtful comments on our article on primary operative management (POM) for pediatric empyema.1 Our study compared POM (VATS or open decortication in the first 2 days of hospitalization) with nonoperative management. The nonoperative management group consisted of all children who were not considered to have undergone POM and thus included all patients initially treated nonoperatively: (1) patients treated with antibiotics alone (24%), (2) patients requiring chest tube placement—with or without fibrinolysis (44%), and (3) patients requiring eventual decortication (30%). We found that POM was associated with a 4-day shorter hospital stay and decreased hospital charges by about $20 000 compared with nonoperative management.
Our primary objective was not to compare POM with intrapleural fibrinolytic therapy, as the Kids' Inpatient Database included few patients with empyema in whom fibrinolysis was recorded (27 of 953 [3%]). While . . . [Full Text of this Article] AUTHOR INFORMATION
RELATED ARTICLE
Primary Operative Management for Pediatric Empyema: Decreases in Hospital Length of Stay and Charges in a National Sample
Su-Ting T. Li and Robert L. Gates
Arch Pediatr Adolesc Med. 2008;162(1):44-48.
ABSTRACT
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RELATED LETTER
Hold Those Scalpels
Michael Weinstein and Eyal Cohen
Arch Pediatr Adolesc Med. 2008;162(7):698.
EXTRACT
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