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Grijalva et al analyzed the Nationwide Inpatient Sample (data from U.S. hospitalizations) and found that the rate of hospitalization for parapneumonic empyema doubled from 3 per 100,000 in 1996, to 6 in 2008. The rate of empyemas due to Streptococcus pneumoniae was stable; the increases were in non-pneumococcal infections like Staphylococcus. Mortality was unchanged overall at 7-8%, but staph empyemas had the highest mortality and longest lengths of stay, unsurprisingly. Thorax 2011;66:663-668. FREE FULL TEXT