Key result
A combination of pleural fluid lactate dehydrogenase > 307 U/L and cholesterol > 1.55 mmol/L had diagnostic accuracy similar to Light's criteria for distinguishing transudates from exudates.
Why the study?
Does the combination of pleural fluid LD and cholesterol accurately distinguish transudates from exudates compared to Light's criteria in patients with pleural effusion?
Observational (n=172)
Does the combination of pleural fluid LD and cholesterol accurately distinguish transudates from exudates compared to Light's criteria in patients with pleural effusion?
A combination of pleural fluid LD and cholesterol offers a diagnostic accuracy similar to Light's criteria for distinguishing transudates from exudates, avoiding the need for simultaneous blood sampling.
Answers are grounded in this paper and cite their sources.
Supports similar accuracy of pleural fluid LD plus cholesterol to Light's criteria; hypothesis-generating and requires prospective validation before practice change.
We aimed to compare the classic Light's criteria with different testing strategies in an effort to improve the accuracy of pleural fluid (PF) categorization. Thirty-two patients with transudates and 140 with exudates on the basis of their clinical diagnosis were entered into the study. We examined the discriminative properties of 10 analytes in the identification of PF, both singly and in combination with an 'or' rule, to see which was best in distinguishing a transudate from an exudate. A combination of PF lactate dehydrogenase (LD) > 307 U/L (two-thirds of the upper limit of the serum LD reference range) with either PF cholesterol > 1.55 mmol/L or PF to serum protein ratio > 0.5 had a diagnostic accuracy similar to that of Light's criteria. We suggest the use of PF LD and cholesterol in combination as an alternative method for distinguishing pleural transudates from exudates. This test combination avoids the need for venepuncture and the simultaneous collection of a blood sample.
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Porcel et al. (2001) conducted an observational in Pleural effusion (n=172). Pleural fluid lactate dehydrogenase and cholesterol combination vs. Light's criteria was evaluated on Diagnostic accuracy in distinguishing transudate from exudate. A combination of pleural fluid lactate dehydrogenase > 307 U/L and cholesterol > 1.55 mmol/L had diagnostic accuracy similar to Light's criteria for distinguishing transudates from exudates.
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