Single-center retrospective study identifies perioperative factors associated with recurrent tuberculous empyema

In a single-center retrospective study of patients with microbiologically proven tuberculous empyema who underwent surgical decortication, higher preoperative C-reactive protein, greater intraoperative blood loss and use of thoracotomy rather than video-assisted thoracoscopic surgery were associated with higher risks of imaging-defined recurrence. A preoperative anti-tuberculous therapy course of at least three months was associated with lower risk, according to the study abstract.

The researchers reviewed patients who received either video-assisted thoracoscopic surgery or open decortication at one center. Recorded variables included demographics, comorbidities, microbiological characteristics, inflammatory and nutritional indices, coagulation markers, operative time, blood loss, surgical approach and the total duration of preoperative anti-tuberculous therapy. Recurrence was defined as a new pleural effusion, cavity or atelectasis seen on follow-up imaging.

Logistic regression was used to identify independent predictors, while area under the curve, calibration and decision-curve analyses were used to assess model performance. Baseline demographic, comorbidity and microbiological characteristics had limited ability to discriminate recurrence. A model combining C-reactive protein, intraoperative blood loss, surgical approach and anti-tuberculous therapy duration achieved an area under the curve of about 0.70, with acceptable calibration and clinical utility in the analysis.

The surgical comparison has an important limitation: video-assisted thoracoscopic surgery was not assigned randomly and was reserved for patients with less complex disease. Its apparently protective association may therefore reflect differences in underlying disease severity rather than a causal advantage of the minimally invasive approach. The retrospective design, single-center setting and non-random allocation further constrain interpretation.

The abstract presents the findings as observational associations. It does not report the number of participants, effect sizes, confidence intervals or recurrence rates, and it does not establish that changing any perioperative factor would prevent recurrence. The available evidence comes from the article abstract, which was published in BMC Infectious Diseases as an accepted open-access version subject to further edits.

Subject of Research: Perioperative factors associated with recurrence after surgical decortication for tuberculous empyema

Article Title: Perioperative predictors of recurrence after decortication for tuberculous empyema

Article References: Chen, L., Chen, G., Gao, M., Wu, J., Zhong, F., Yu, G., & Zhu, P. (2026). Perioperative predictors of recurrence after decortication for tuberculous empyema. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14393-1

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14393-1

Keywords: tuberculous empyema, decortication, disease recurrence, anti-tuberculous therapy, C-reactive protein, intraoperative blood loss, thoracotomy, video-assisted thoracic surgery, retrospective study, risk prediction, Perioperative, predictors