Quality of Life after Pyothorax Surgery in the Fes-Meknes Region, Morocco

Abstract

Pyothorax is defined by the presence of a purulent, cloudy, or clear fluid containing altered polymorphonuclear cells and germs between the two layers of the pleura, as observed through direct examination. The progression to chronicity in pleural empyema results from a failure in medical treatment or a delayed diagnosis. In this case, surgery aims to restore respiratory function and prevent recurrence.

The objective of this work is to evaluate the quality of life of patients after pyothorax surgery, as well as the overall impact of this surgical intervention in the medium and long term, and to identify the associated factors.

A cross-sectional study was conducted among patients with pyothorax who underwent surgery in the thoracic surgery department at Hassan II University Hospital in Fes during the period from December 2012 to December 2020. Quality of life was assessed using the SF-12 questionnaire, which was translated and validated in Moroccan Arabic dialect.

We included 72 subjects in the study. The mean age of the patients was 38.75±15.7 years, with 69.4% being male. The most common etiology was pleuropulmonary tuberculosis, found in 38 patients (52.8%).

The average mental quality of life score was 46.11 ±8.14, and the physical score was 50.12 ±6.76. There is a statistically significant association between quality of life and the presence of a history of pleural tuberculosis, secondary pyothorax following subacute pleuritis in its physical component, dyspnea stage, WHO (World Health Organization) score, pain level, occurrence of postoperative infections, weight gain in its physical component, appetite, sleep quality, hospital stay satisfaction in its physical component, and treatment response.

Surgery is the ultimate therapeutic option for treating chronic pyothorax, as it can cure or improve the quality of life of these individuals in the medium and long term.