The effect of age on the accuracy of Light's criteria

This study aimed to investigate the effects of age on the sensitivity, specificity, and accuracy of Light's criteria to differentiate exudative from transudative pleural effusion.

A testing cohort from China and a validation cohort from Spain were used for data analysis. The testing cohort included 302 patients (59 transudates and 243 exudates) with undiagnosed pleural effusion. The validation cohort comprised 400 patients (200 transudates and 200 exudates) divided into two groups according to age (200 patients aged 50-65 years and 200 patients aged 80-95 years). The effects of age on the sensitivity, specificity, and accuracy of Light's criteria were determined by sampling patients with different age limits.

In the testing cohort, the sensitivity and specificity of Light's criteria for exudate were 0.91 and 0.73, respectively. In the validation cohort, the sensitivity was 0.99 and 0.97, and the specificity of Light's criteria for exudate was 0.73 and 0.68, respectively, by age group. The diagnostic accuracy metrics (sensitivity, specificity, and accuracy) of Light's criteria and its items tended to decrease with age.

Age should be considered when interpreting the Light's criteria.