2025 Volume 39 Issue 4 Pages 314-319
Recurrence risk factors after acute pyothorax surgery requiring surgical re-intervention are still unclear. We have focused on causative bacteria derived from the oral flora and perioperative intensive oral care (OC) since 2019. Fifty-seven patients who underwent pyothorax surgery at our institution from 2009 to 2022 were divided into two groups: 10 patients underwent re-intervention (R group) and 47 patients underwent surgery alone (S group). Clinical factors were compared between the two groups retrospectively. OC was performed in 15% (n=5/33) of the patients until 2018, while 63% (n=15/24) of the patients received OC after 2019. Of these, tooth extraction was performed in 5% (n=4/20). The preoperative prognostic nutritional index (PNI) (23.8) in the R group was significantly lower than that (28.2) in the S group (p=0.009). The calculated cut-off value of PNI from the ROC curve was 25.5. The rate of patients with OC was lower in the R group (10%, n=1/10) compared with that in the S group (40%, n=19/47). Especially in patients with low PNI (<25.5, n=20), 50% (n=7/14) of patients without OC required re-intervention, whereas no re-intervention was necessary in patients with OC (n=0/6) (p=0.032). Low PNI was associated with surgical re-intervention after pyothorax surgery, and intensive perioperative OC should be provided.
