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Published on: November 10, 2023
Procedures Performed during Hospitalizations for Malignant Pleural Effusions: Data from the 2012 National Inpatient
Marc Fortin1, Niloofar Taghizadeh2, Alain Tremblay2
1Division of Respiratory Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Quebec City, Québec, Canada.
Background:
Malignant pleural effusions (MPE) are a common clinical problem. Little is known about the burden of MPE and of the treatments used to alleviate its symptoms on the United States Health Care System.
Objectives:
We aimed to obtain a better portrait of inpatient pleural procedures performed in the United States.
Methods:
We conducted a retrospective analysis of MPE-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, Agency for Healthcare Research and Quality (HCUP-NIS 2012). Descriptive statistics were used to analyze procedures performed and their complications. Univariate and multivariate logistic regression models were used to explore the relationship between procedures performed and inpatient mortality and length of stay.
Results:
Among the 126,825 hospital admissions with a diagnosis of MPE, 72,240 included one or more pleural procedures. Thoracentesis (54,070) was the most frequently performed procedure followed by chest tube placement (23,035), chemical pleurodesis (10,240), and thoracoscopy (6,615). Hospitalization for lung and breast cancer was more likely to include pleural procedures compared to hospitalization for other types of cancer (59.2 and 65.6%, respectively, p < 0.0001). Chemical pleurodesis through a chest tube compared to thoracoscopic chemical pleurodesis was performed more frequently (57 vs. 43%, p < 0.001) and associated with a longer hospital stay (4.9 vs. 5.9 days, p < 0.001).
Conclusions:
Hospital admissions for MPE represent a large burden on the US Health Care System. Many hospitalizations are associated with procedures not expected to reduce the recurrence rate of this condition.
Insights
Malignant pleural effusions (MPE) place a significant burden on US healthcare. Many inpatient procedures for MPE do not effectively reduce recurrence rates, highlighting a need for improved treatment strategies.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Oncology
Background:
- Malignant pleural effusions (MPE) are a common clinical issue with poorly understood healthcare system impact.
- Current data on the burden of MPE and its treatments in the US are limited.
Purpose of the Study:
- To characterize inpatient pleural procedures performed in the United States.
- To analyze the utilization and outcomes of procedures for malignant pleural effusions.
Main Methods:
- Retrospective analysis of the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2012.
- Descriptive statistics and logistic regression models were used to assess procedure frequency, complications, mortality, and length of stay.
Main Results:
- Over 126,000 hospital admissions involved MPE, with over 72,000 including pleural procedures.
- Thoracentesis was most common, followed by chest tube placement, chemical pleurodesis, and thoracoscopy.
- Procedures were more frequent in lung and breast cancer patients; chest tube chemical pleurodesis was more common than thoracoscopic, associated with longer hospital stays.
Conclusions:
- Hospitalizations for MPE represent a substantial burden on the US healthcare system.
- Many procedures performed during MPE hospitalizations may not be effective in reducing recurrence.
- Further research into optimizing MPE management is warranted.
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