2024 Volume 46 Issue 5 Pages 271-276
Background. Urokinase fibrinolytic therapy shortens hospital stays and helps avoid surgical intervention in cases with complicated parapneumonic effusion. However, the impact of supply related urokinase deficit in February 2022 on treatment outcomes remains unclear. Methods. We retrospectively analyzed data from 113 patients admitted to our respiratory department with complicated parapneumonic effusion who underwent thoracic drainage between January 2014 and January 2024. Results. In this cohort, 43% of the patients were high-risk patients (according to the RAPID score). Surgical intervention was first performed under general anesthesia with thoracoscopic decortication. Following the shortage in urokinase supply, the prevalence of fibrinolytic therapy decreased from 63% to 16%, whereas the prevalence of thoracoscopic surgery increased from 27% to 52%. The time to thoracoscopic surgery and the surgical duration were shortened by 4 days and 33 min, respectively. No impact on outcome, length of hospital stay, or hospital costs was detected. Conclusion. Early thoracoscopic surgery is a potential alternative to urokinase fibrinolytic therapy that does not worsen outcomes.
