{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:42:23Z","timestamp":1787067743610,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To identify factors associated with complicated parapneumonic pleural effusion\/empyema (CPPE\/empyema) in inpatients with community-acquired pneumonia (CAP) and to build a mathematical model for CPPE\/empyema. Methods: This is an observational case\u2013control study nested within a retrospective cohort, based on clinical practice, and including adults hospitalized with CAP from 2009 to 2019. Cases and controls were defined according to diagnosis of CPPE\/empyema during admission. For each case, two controls were randomly selected and matched for the period of admission to avoid seasonality bias. Explanatory variables included demographic, analytical, clinical, and radiological data; treatment with corticosteroids on admission; prognostic and CAP severity scales; comorbidity; and the interval between symptoms onset and admission. Results: Of 4372 pneumonias reviewed, 2015 were excluded due to pleural effusion, blunting of the costophrenic angle without thoracentesis, or heart failure. Of the remaining 2357 patients, 106 developed CPPE\/empyema (cases), and 212 were selected as controls. Factors associated with CPPE\/empyema were pleuritic pain (odds ratio [OR] 7.42, 95% confidence interval [CI] 3.83\u201314.38), multilobar radiological involvement (OR 4.48, 95% CI 2.26\u20138.88), and leukocytosis (OR 4.12, 95% CI 1.94\u20138.76). Corticosteroids showed a protective effect (OR 0.24, 95% CI 0.09\u20130.61). Age (OR 0.99, 95% CI 0.97\u20131.02; p = 0.56) and sex (OR 1.91, 95% CI 0.94\u20133.88; p = 0.074) were adjustment variables. The area under the receiver operating characteristic curve was 0.847 (95% CI 0.772\u20130.921). Conclusions: Pleuritic pain, multilobar radiological involvement, and leukocytosis are associated with CPPE\/empyema in inpatients with CAP. Treatment with corticosteroids upon admission seems to be a protective factor. The discriminative capacity of the resulting multivariable model presents moderate\/high accuracy.<\/jats:p>","DOI":"10.3390\/jcm14051739","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T03:18:22Z","timestamp":1741144702000},"page":"1739","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factors Associated with Complicated Parapneumonic Pleural Effusion\/Empyema in Patients with Community-Acquired Pneumonia: The EMPIR Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-901X","authenticated-orcid":false,"given":"Rosa Mar\u00eda","family":"Bravo Jover","sequence":"first","affiliation":[{"name":"Internal Medicine Service, Elda General University Hospital, 03600 Elda, Spain"},{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3793-9786","authenticated-orcid":false,"given":"Vicente F.","family":"Gil-Guillen","sequence":"additional","affiliation":[{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"},{"name":"Research Unit, Elda General University Hospital, 03600 Elda, Spain"},{"name":"Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 03550 San Juan de Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"P\u00e9rez Barba","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Elda General University Hospital, 03600 Elda, Spain"},{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6947-7531","authenticated-orcid":false,"given":"Jose Antonio","family":"Quesada","sequence":"additional","affiliation":[{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"},{"name":"Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 03550 San Juan de Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda L\u00f3pez","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Orihuela Hospital, 03300 Orihuela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Garc\u00eda Soriano","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Elda General University Hospital, 03600 Elda, Spain"},{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-0077","authenticated-orcid":false,"given":"Mar\u00eda de los Reyes","family":"Pascual P\u00e9rez","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Elda General University Hospital, 03600 Elda, Spain"},{"name":"Clinical Medicine Department, University Miguel Hern\u00e1ndez de Elche, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1513\/pats.200510-113JH","article-title":"Parapneumonic effusions and empyema","volume":"3","author":"Light","year":"2006","journal-title":"Proc. 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