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European Radiology
Published in: European Radiology 2/2022

01-02-2022 | Lung Abscess | Interventional

Percutaneous transthoracic catheter drainage for lung abscess: a systematic review and meta-analysis

Authors: Jong Hyuk Lee, Hyunsook Hong, Mario Tamburrini, Chang Min Park

Published in: European Radiology | Issue 2/2022

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Abstract

Objectives

To evaluate the outcomes of patients receiving image-guided percutaneous catheter drainage (PCD) for lung abscesses in terms of treatment success, major complications, and mortality as well as the predictors of those outcomes.

Methods

Embase and OVID-MEDLINE databases were searched to identify studies on lung abscesses treated with PCD that had extractable outcomes. The outcomes were pooled using a random-intercept logistic regression model. Multivariate Firth’s bias-reduced penalised-likelihood logistic regression analyses were performed to identify predictors of treatment success and complications. Methodological quality was assessed by summing scores of binary responses to items regarding selection, ascertainment of exposure and outcome, causality of follow-up duration, and reporting.

Results

From 26 studies with acceptable methodological quality (median score, 4; range, 3–5), 194 patients were included. The pooled rates of treatment success and major complications were 86.5% (95% confidence interval [CI], 78.5–91.8%; I2 = 23%) and 8.1% (95% CI, 4.1–15.3%; I2 = 26%), respectively. Four patients eventually died from uncontrolled lung abscesses (pooled rate, 1.5%; 95% CI, 0.2–11.1%; I2 = 36%). Malignancy-related abscess (odds ratio [OR], 0.129; 95% CI, 0.024–0.724; p = .022) and the occurrence of a major complication (OR, 0.065; 95% CI, 0.02–0.193; p < .001) were significant predictors of treatment failure. Traversing normal lung parenchyma was the only significant risk factor for major complications (OR, 27.69; 95% CI, 7.196–123.603; p < .001).

Conclusion

PCD under imaging guidance was effective for lung abscess treatment, with a low complication rate. Traversal of normal lung parenchyma was the sole risk factor for complications, and malignancy-related abscesses and the occurrence of major complications were predictors of treatment failure.

Key Points

• The pooled treatment success rate of PCD for lung abscess was reasonably high (86.5%); malignancy-related abscesses and the occurrence of a major complication were predictors of treatment failure.
• The pooled rate of percutaneous transthoracic catheter drainage-related major complications was 8.1% and traversing normal lung parenchyma by the catheter was the only risk factor.
• The pooled mortality rate from uncontrolled lung abscesses with percutaneous transthoracic catheter drainage was low.
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Metadata
Title
Percutaneous transthoracic catheter drainage for lung abscess: a systematic review and meta-analysis
Authors
Jong Hyuk Lee
Hyunsook Hong
Mario Tamburrini
Chang Min Park
Publication date
01-02-2022
Publisher
Springer Berlin Heidelberg
Keyword
Lung Abscess
Published in
European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08149-5

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