Current therapeutic approach in patients with pleural infections: results from a multicentre Italian study (INPLE study)

<bold>Backgrounds:</bold> The health burden of pleural infection (PI) is noteworthy, and the optimal therapeutic approach is still a matter of concerns. <bold>Objectives:</bold> To assess the type and the timing of first-line interventions and their clinical outcomes in patients with PI. <bold>Methods:</bold> All patients admitted in the hospital between 2015 and 2021 with diagnosis of PI were included in this multicentre retrospective study. We retrieved clinical data including the timing and type of pleural interventions, the length of hospital stay (LOS), surgical referral rate (SR) and 90-days mortality. <bold>Results:</bold> We enrolled 495 Pts. Chest drain insertion was the most common first-line approach (42.2%), followed by medical thoracoscopy (MT) (24.4%), thoracentesis (11,7%) and surgery at onset (13.5%). 53,3% of interventions were performed within the first 48 hours. We found that an initial approach with thoracentesis or chest drain insertion was associated with a higher probability of SR compared to MT (OR 6.0, 95%CI 1.8-23.9, 7.4, 95%CI 2.8-25.6, p<0.01 and p<0.01 respectively) (Fig. 1). The median LOS was 15 days (IQR 15.0-24.0) and the MT subgroup had a shorter hospital stay (median 13 days, IQR 8.0-20.0). <bold>Conclusions:</bold> These results showed that MT is associated with a shorter LOS and lower SR rate, particularly when timely performed. However, further studies are needed to definitely assess the role of MT in PI management. <fig><object-id>erj;64/suppl_68/PA2551/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>