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Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
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Mortality among patients with pleural effusion undergoing thoracentesis
Erin M DeBiasi1, Margaret A Pisani1, Terrence E Murphy2
1Division of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT, USA.
The European Respiratory Journal
|April 4, 2015
Summary
Patients undergoing thoracentesis for pleural effusion face high mortality rates, especially with malignant causes or bilateral effusions. Non-malignant causes like heart or kidney failure also show significant mortality.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Epidemiology
Background:
- Pleural effusion affects 1.5 million Americans annually, with ~178,000 requiring thoracentesis.
- Malignant pleural effusion is linked to poor prognosis, but mortality in non-malignant cases is less understood.
Purpose of the Study:
- To evaluate the short- and long-term mortality associated with various etiologies of pleural effusion.
- To compare mortality risks between unilateral and bilateral thoracentesis procedures.
Main Methods:
- Prospective cohort study of 308 patients undergoing thoracentesis.
- Etiology determination using standardized criteria and chart review.
- Mortality assessment at 30 days and 1 year post-procedure.
Main Results:
- Malignant pleural effusion showed the highest 30-day (37%) and 1-year (77%) mortality.
- Significant mortality observed for benign etiologies: multiple benign (29%/55%), congestive heart failure (22%/53%), and renal failure (14%/57%).
- Bilateral pleural effusions were associated with higher 30-day (47% vs. 17%) and 1-year (69% vs. 36%) mortality compared to unilateral effusions.
Conclusions:
- Thoracentesis for pleural effusion is associated with substantial short- and long-term mortality.
- Mortality risk varies significantly by effusion etiology, with malignant causes and certain benign conditions posing the greatest risk.
- Bilateral pleural effusions represent a distinct risk factor for increased mortality.
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