Objectives: To observe trends for empyema admissions in the context of pneumonia and croup admissions in Scottish children over a 25 year period to 2005.
Design: Whole population study with retrospective analysis using diagnosis codes (ICD 9 &10).
Setting: All non-obstetric and non-psychiatric hospitals in Scotland.
Participants: Patients <15yrs admitted with a diagnosis of empyema, pneumonia or croup between 1st January 1981 and 31st December 2005.
Results: There were 217 paediatric empyema admissions (76 aged 1-4 years). 24,312 pneumonia admissions (11,299 aged 1-4 years), and 31,120 (20,332 aged 1-4 years) for croup. Empyema increased after 1998 from <10 per million children/year to a peak of 37 per million in 2005. In the 1-4 year group empyema admissions rose from the late 1990s from 6.5 per million/year between 1981-1998 to 66 per million in 2005. Annual admission rates for pneumonia remained unchanged in most children. However among 1-4yr olds, admissions rose steadily by an average of 50 per million/year between 1981 -2005. Admission rates for croup remained stable over the period.
Conclusions: Our whole population study shows that the incidence of childhood empyema has risen since 1998 and continues to rise independent of pneumonia. Croup admissions remained stable suggesting changes in coding or admission policies are unlikely to explain the trends. Our observations suggest the rise in empyema is not related to an increase in pneumonia. Changes in bacterial pathogenicity and/or host susceptibility could be important.
- Empyema, pleural
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