Table 5.

Surgical risk assessment

Lower risk	Higher risk
Risk of Aspergillus empyema
Intrapulmonary cavity	Pleural involvement including thickening
Solid lesion	Cavitary lesion with fungal ball or fluid level
Smooth-walled cavity	Irregular or bumpy cavity surface (indicating fungal growth on surface of cavity)
Single lesion or small, localised collection of several interrelated lesions	Extensive multicavity lesion
	Prior radiotherapy to proposed surgical site
	Prior lobectomy or other thoracic surgery
Risk of space infection
Localised lesion and lobectomy or segmental resection	Second lobectomy or pneumonectomy
Chest wall normal	Scoliosis or ankylosing spondylitis
	Other pleural/pulmonary disease preventing full lung mobilisation
	Immunosuppression
	Intrapleural spillage during surgery
Risk of overall poor outcome
Good pulmonary function	FEV1 <1.0. L/sec
Young	Older ( >70 years)
Well nourished	Thin, low BMI or reduced albumin
No other significant comorbidities	Diabetes, other concurrent pulmonary infection (ie non-tuberculous mycobacterial or Pseudomonas infection)
	Other associated significant comorbidities (i.e. lymphoma, autoimmune hepatitis, organ transplantation)