Mortality Among Hospitalized Patients With Pleural Effusions. A Multicenter, Observational, Prospective Study

Frontiers in Medicine

article

Eleftherios Markatis¹  Garifallia Perlepe²  Andreas Afthinos¹  Konstantinos Pagkratis¹  Charalampos Varsamas²  Eleftheria Chaini¹  Ilias C. Papanikolaou¹  Konstantinos I. Gourgoulianis² 

[1] Pulmonary Department, Corfu General Hospital;Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly

关键词: mortality;    prognostic factors;    pleural effusion;    hospitalized patients (inpatients);    survival;   

DOI  :  10.3389/fmed.2022.828783

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Data regarding the prognostic significance of pleural effusion (PE) are scarce. Objective Explore the impact of PE on mortality among hospitalized patients. Methods Multicenter prospective observational study. Patients that underwent computed tomography (thorax and/or abdomen) and in which PE was detected, were admitted to the study. PE was classified by size on CT, anatomical distribution, diagnosis, and Light's criteria. Charlson comorbidity index (CCI), APACHE II, and SOFA score were calculated. Mortality at 1 month and 1 year were recorded. Results Five hundred and eight subjects, mean age 78 years. Overall mortality was 22.6% at 1 month and 49.4% at 1 year. Bilateral effusions were associated with higher mortality than unilateral effusions at 1 month (32 vs. 13.3%, p = 0.005) and large effusions with higher mortality than small effusions at 1 year (66.6 vs. 43.3%, p < 0.01). On multivariate analysis age, CCI, APACHE II, SOFA score, and bilateral distribution were associated with short-term mortality, while long-term significant predictors were CCI, APACHE II, SOFA, and malignant etiology. Exudates (excluding MPE) exhibited a survival benefit at both 1 month and 1 year but due to the smaller sample, fluid characteristics were not included in the multivariate analysis. Conclusions Pleural effusion is a marker of advanced disease. Mortality is higher within the first month in patients with PEs related to organ failure, while patients with MPE have the worst long-term outcome. Independent predictors of mortality, apart from CCI, APACHE II, and SOFA scores, are age and bilateral distribution in the short-term, and malignancy in the long-term.

【 授权许可】

CC BY