Key result
Malignancy was the most common cause of chronic pleural effusion (65.9%), and chemical pleurodesis achieved a 65% complete response rate compared to 55% for mechanical pleurodesis.
Why the study?
Pleural effusion is widespread, prompting an investigation into its malignancy-related causes among patients referred to tertiary health care centers and an evaluation of response rates to different pleurodesis techniques.
Cross-Sectional (n=144)
Absolute Event Rate: 65% vs 55%
Malignancy is the predominant cause of chronic pleural effusion in this tertiary setting, and chemical pleurodesis provides a high complete response rate for malignant effusions.
Malignancy predominates among referred chronic pleural effusions; leaves open optimal pleurodesis technique selection for prospective trials.
Background: Pleural effusion, the pathological accumulation of fluid in the pleural space, is widespread. This study investigates pleural effusion in terms of malignancy among patients referred to tertiary health care centers and evaluates the response rates to different pleurodesis techniques. Methods: This cross-sectional study enrolled all patients with pleural effusion referred to a tertiary health care center. Laboratory data, including White Blood Cell count and differentiation (WBC), Hemoglobin levels (HB), Erythrocyte Sedimentation Rate (ESR), and biochemical analysis results of the pleural fluid (protein, glucose, and lactate dehydrogenase) were recorded. Data from pleural fluid cytopathological examination, including cell count, cell types, gram staining, and pleural fluid culture, were also documented. Patients undergoing pleurodesis were assessed for response rates, which were categorized as complete, partial, or no response based on clinical and radiological criteria. Collected data were subjected to statistical analysis. Results: The study investigated 144 patients with chronic pleural effusion, with an average age of 47.59 years. Of these, 97 patients (66%) were male and 47 patients (34%) were female. The most common cause of chronic pleural effusion was malignancy, with a prevalence of 65.9%. Among patients treated with pleurodesis, the overall response rate was 78.4%, with chemical pleurodesis achieving a higher complete response rate (65%) compared to mechanical pleurodesis (55%). Other prevalent causes of chronic pleural effusion, in descending order, included heart failure, liver cirrhosis, chronic kidney failure, and unknown factors. Conclusion: This study highlights malignancy and chronic heart failure as the predominant etiologies of chronic pleural effusion in a tertiary healthcare setting. Furthermore, it emphasizes the efficacy of pleurodesis techniques, with chemical pleurodesis demonstrating superior outcomes. These findings offer valuable insights into the pathogenesis and management of chronic pleural effusion.
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Shirzadi et al. (2025) conducted a cross-sectional in Chronic pleural effusion (n=144). Chemical pleurodesis vs. Mechanical pleurodesis was evaluated on Complete response rate to pleurodesis. Malignancy was the most common cause of chronic pleural effusion (65.9%), and chemical pleurodesis achieved a 65% complete response rate compared to 55% for mechanical pleurodesis.
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