Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study

Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy...
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Autor*in:	Taniguchi, Jumpei [verfasserIn] Matsui, Hiroki Nagai, Tatsuya Otsuki, Ayumu Ito, Hiroyuki Sugimura, Hiroshi Nakashima, Kei

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Drainage Empyema Retrospective study Pleural infection Urokinase

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: BMC pulmonary medicine - London : BioMed Central, 2001, 23(2023), 1 vom: 21. Juli
Übergeordnetes Werk:	volume:23 ; year:2023 ; number:1 ; day:21 ; month:07

Links:	Volltext

DOI / URN:	10.1186/s12890-023-02559-5

Katalog-ID:	SPR052334376

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520			\|a Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered.
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allfields	10.1186/s12890-023-02559-5 doi (DE-627)SPR052334376 (SPR)s12890-023-02559-5-e DE-627 ger DE-627 rakwb eng Taniguchi, Jumpei verfasserin aut Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213 Matsui, Hiroki aut Nagai, Tatsuya aut Otsuki, Ayumu aut Ito, Hiroyuki aut Sugimura, Hiroshi aut Nakashima, Kei aut Enthalten in BMC pulmonary medicine London : BioMed Central, 2001 23(2023), 1 vom: 21. Juli (DE-627)335489125 (DE-600)2059871-3 1471-2466 nnns volume:23 year:2023 number:1 day:21 month:07 https://dx.doi.org/10.1186/s12890-023-02559-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 21 07
spelling	10.1186/s12890-023-02559-5 doi (DE-627)SPR052334376 (SPR)s12890-023-02559-5-e DE-627 ger DE-627 rakwb eng Taniguchi, Jumpei verfasserin aut Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213 Matsui, Hiroki aut Nagai, Tatsuya aut Otsuki, Ayumu aut Ito, Hiroyuki aut Sugimura, Hiroshi aut Nakashima, Kei aut Enthalten in BMC pulmonary medicine London : BioMed Central, 2001 23(2023), 1 vom: 21. Juli (DE-627)335489125 (DE-600)2059871-3 1471-2466 nnns volume:23 year:2023 number:1 day:21 month:07 https://dx.doi.org/10.1186/s12890-023-02559-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 21 07
allfields_unstemmed	10.1186/s12890-023-02559-5 doi (DE-627)SPR052334376 (SPR)s12890-023-02559-5-e DE-627 ger DE-627 rakwb eng Taniguchi, Jumpei verfasserin aut Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213 Matsui, Hiroki aut Nagai, Tatsuya aut Otsuki, Ayumu aut Ito, Hiroyuki aut Sugimura, Hiroshi aut Nakashima, Kei aut Enthalten in BMC pulmonary medicine London : BioMed Central, 2001 23(2023), 1 vom: 21. Juli (DE-627)335489125 (DE-600)2059871-3 1471-2466 nnns volume:23 year:2023 number:1 day:21 month:07 https://dx.doi.org/10.1186/s12890-023-02559-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 21 07
allfieldsGer	10.1186/s12890-023-02559-5 doi (DE-627)SPR052334376 (SPR)s12890-023-02559-5-e DE-627 ger DE-627 rakwb eng Taniguchi, Jumpei verfasserin aut Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213 Matsui, Hiroki aut Nagai, Tatsuya aut Otsuki, Ayumu aut Ito, Hiroyuki aut Sugimura, Hiroshi aut Nakashima, Kei aut Enthalten in BMC pulmonary medicine London : BioMed Central, 2001 23(2023), 1 vom: 21. Juli (DE-627)335489125 (DE-600)2059871-3 1471-2466 nnns volume:23 year:2023 number:1 day:21 month:07 https://dx.doi.org/10.1186/s12890-023-02559-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 21 07
allfieldsSound	10.1186/s12890-023-02559-5 doi (DE-627)SPR052334376 (SPR)s12890-023-02559-5-e DE-627 ger DE-627 rakwb eng Taniguchi, Jumpei verfasserin aut Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213 Matsui, Hiroki aut Nagai, Tatsuya aut Otsuki, Ayumu aut Ito, Hiroyuki aut Sugimura, Hiroshi aut Nakashima, Kei aut Enthalten in BMC pulmonary medicine London : BioMed Central, 2001 23(2023), 1 vom: 21. Juli (DE-627)335489125 (DE-600)2059871-3 1471-2466 nnns volume:23 year:2023 number:1 day:21 month:07 https://dx.doi.org/10.1186/s12890-023-02559-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 21 07
language	English
source	Enthalten in BMC pulmonary medicine 23(2023), 1 vom: 21. Juli volume:23 year:2023 number:1 day:21 month:07
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format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Drainage Empyema Retrospective study Pleural infection Urokinase
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container_title	BMC pulmonary medicine
authorswithroles_txt_mv	Taniguchi, Jumpei @@aut@@ Matsui, Hiroki @@aut@@ Nagai, Tatsuya @@aut@@ Otsuki, Ayumu @@aut@@ Ito, Hiroyuki @@aut@@ Sugimura, Hiroshi @@aut@@ Nakashima, Kei @@aut@@
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In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. 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author	Taniguchi, Jumpei
spellingShingle	Taniguchi, Jumpei misc Drainage misc Empyema misc Retrospective study misc Pleural infection misc Urokinase Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
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topic_title	Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study Drainage (dpeaa)DE-He213 Empyema (dpeaa)DE-He213 Retrospective study (dpeaa)DE-He213 Pleural infection (dpeaa)DE-He213 Urokinase (dpeaa)DE-He213
topic	misc Drainage misc Empyema misc Retrospective study misc Pleural infection misc Urokinase
topic_unstemmed	misc Drainage misc Empyema misc Retrospective study misc Pleural infection misc Urokinase
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title	Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
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title_full	Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
author_sort	Taniguchi, Jumpei
journal	BMC pulmonary medicine
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author_browse	Taniguchi, Jumpei Matsui, Hiroki Nagai, Tatsuya Otsuki, Ayumu Ito, Hiroyuki Sugimura, Hiroshi Nakashima, Kei
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doi_str_mv	10.1186/s12890-023-02559-5
title_sort	association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
title_auth	Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
abstract	Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. © The Author(s) 2023
abstractGer	Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. © The Author(s) 2023
abstract_unstemmed	Background Pleural infection, an infection of the pleural space, is frequently treated with antibiotics and thoracic tube drainage. In case of insufficient drainage, an intrapleural fibrinolytic agent is considered before surgical intervention. However, the effectiveness of fibrinolytic monotherapy is still controversial. Therefore, we aimed to examine the association between urokinase monotherapy and treatment failure in patients with pleural infection. Methods In this retrospective observational study, patients with pleural infection underwent chest tube insertion were divided into two groups including patients treated with or without intrapleural instillation of urokinase. The propensity score overlap weighting was used to balance the baseline characteristics between the groups. Treatment failure was defined by the composite primary outcome of in-hospital death and referral for surgery. Results Among the 94 patients, 67 and 27 patients were in the urokinase and non-urokinase groups, respectively. Urokinase monotherapy improved the composite outcome between the groups (19.4% vs. 48.1%, p = 0.01). After adjusting using propensity score overlap weighting, urokinase monotherapy improved the composite outcome compared to the non-urokinase group (19.0% vs. 59.5%, p = 0.003). Conclusions Urokinase monotherapy can be an important nonsurgical treatment option for patients with pleural infection. Trial registration The participants were retrospectively registered. © The Author(s) 2023
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title_short	Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study
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author2	Matsui, Hiroki Nagai, Tatsuya Otsuki, Ayumu Ito, Hiroyuki Sugimura, Hiroshi Nakashima, Kei
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up_date	2024-07-04T02:24:24.664Z
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Association between intrapleural urokinase monotherapy and treatment failure in patients with pleural infection: a retrospective cohort study

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