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Massive Pleural Fluid Collection in Adult Nigerians
Kelechi E Okonta1, Emmanuel O Ocheli1, Peter D Okoh1
1Cardiothoracic Surgery Unit, Department of Surgery, University of Port Harcourt Teaching Hospital, PMB 6173, Port Harcourt, Rivers State, Nigeria.
Abstract:
Background. There are no available literatures on massive pleural effusions (MPE) in our country. Aim. To determine the aetiology of MPE and compare the mortality rate between malignant and nonmalignant MPE in adult Nigerians. Methods. A prospective study of all the patients diagnosed with nontraumatic pleural fluid collections for one year in two tertiary federal hospitals in Southern Nigeria. A total of 101 consecutive patients with pleural fluid collections were studied. Diagnoses were made by clinical features and laboratory and radiological investigations. Results. Forty-eight patients (47.5%) had MPE with a mean age of 43 years ± 14.04 and 35 were females. Thirty patients (62.5%) were diagnosed with nonmalignant conditions (21 from pulmonary tuberculosis (PTB) and 9 from other causes). Haemorrhagic pleural collections were from malignancy in 12 (30.8%) and from PTB in 6 (15.4%). Straw-coloured collections were from malignancy in 9 (23.1%), from PTB in 8 (20.1%), and from posttraumatic exudative effusion in 3 (7.7%). Compared with nonmalignant MPE, patients with malignant collections had higher mortality within 6 months (8/18 versus 0/30 with a P value of 0.000). Conclusion. The presentation of patients with nontraumatic haemorrhagic or straw-coloured MPE narrows the diagnosis to PTB and malignancy with MPE cases being a marker for short survival rate.
Insights
Massive pleural effusions (MPE) in Nigerian adults are often caused by pulmonary tuberculosis (PTB) or malignancy. Malignant MPE is associated with a significantly higher mortality rate compared to nonmalignant MPE.
Area of Science:
- Pulmonology
- Oncology
- Infectious Diseases
Background:
- Limited existing literature on massive pleural effusions (MPE) in Nigeria.
- Need to understand the causes and outcomes of MPE in the Nigerian adult population.
Purpose of the Study:
- To determine the aetiology of MPE in adult Nigerians.
- To compare mortality rates between malignant and nonmalignant MPE.
Main Methods:
- Prospective study conducted over one year in two Nigerian tertiary hospitals.
- Inclusion of 101 consecutive adult patients with nontraumatic pleural fluid collections.
- Diagnosis based on clinical, laboratory, and radiological investigations.
Main Results:
- 47.5% of patients presented with MPE; the most common cause was nonmalignant conditions (62.5%), primarily pulmonary tuberculosis (PTB).
- Malignancy was a significant cause of hemorrhagic and straw-colored MPE.
- Malignant MPE showed a significantly higher 6-month mortality rate (P=0.000) compared to nonmalignant MPE.
Conclusions:
- Nontraumatic hemorrhagic or straw-colored MPE in Nigeria strongly suggests PTB or malignancy.
- MPE is a critical indicator of a poor prognosis and short survival rate.
- Further research and clinical attention are warranted for MPE management in Nigeria.
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