Benefit of serum-effusion albumin gradient in congestive heart failure patients

To compare between light's criteria and serum-effusion (S-E) albumin gradient in diagnosis of transudate effusion in congestive heart failure (CHF) patients.

Eighty-six patients who had pleural effusion and suspected CHF were enrolled in the present study between October 2008- September 2010. Suspected CHF was defined by clinical or echocardiography. Inform consents were given by all volunteers. Exclusion criteria was previous thoracotomy or coronary bypass graft 3 months before present study. Thoracocentesis was done to evaluate transudate effusion by light's criteria and S-E albumin gradient > 1.2 mg/dl.

12 (13.95%), 56 (65.11%), 17 (19.76%) of all were pure pleural disease, pure CHF, combination of pleural disease and CHF. Sensitivity/specificity/accuracy of S-E albumin gradients and light's criteria in diagnosis of CHF (both pure and combined) were 90.1/33.3/80.2%, 64.7/80.0/67.4%. No correlation between amount of diuretic drug and "exudate" criteria from lights' (p = 0. 66). 25 (27.2%) patients were previous post thoracotomy or coronary bypass graft. 7 of 25 patients had loculated effusion. There was correlation between previous surgery with loculated effusion and effusion from combination of pleural disease and CHF (p = 0.22).

There is benefit to use S-E albumin gradient > 1.2 mg/dl to diagnosis patients who were suspected CHF with or without pleural disease. The authors recommended to use S-E albumin gradients combined with Light's criteria in suspected CHF patients.