Introduction:

The need to address complex, infectious thoracic problems with high-risk techniques on elderly patients increases the surgical risk.

Objective:

To describe the evolution of patients subjected to drainage of lung and pleura applying a strategy of surgical selection according to the surgical risk.

Material and methods:

A cross-sectional study of 139 patients was conducted, 75.5% with suppuration of pleura and 24.5% of lung, whose treatment was surgical. High-risk patients ASA III to IV were determined, with cardiovascular and respiratory disease.

Results:

Male patients and those 60 years and older dominated. In those ASA I and II, resection of the pulmonary suppuration and decortication of the pleura was performed more frequently; in those ASA III and IV, and high-risk, pneomostomy on the lung suppuration and the drainage with washing up and thoracic window in the pleura dominated, all under local anesthesia. Those submitted to major interventions were at 2.36 times greater risk of complication, with a weak negative correlation between hospital stay and the patient’s age; most complications were clinical, with low mortality rate.

Conclusion:

The implementation of a surgical strategy based on surgical risk proved to be an effective method for the treatment and outcome of the patients with lung and pleura suppuration.

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