“Comparative Analysis of Biochemical Parameters to Differentiate Transudative and Exudative Pleural Fluid”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Background: Light’s criteria is the gold standard to differentiate transudative pleural effusion (PE) from exudative PE, but it requires four biochemical estimations which, in developing countries such as India, may not be feasible in every patient due to economic constraints. Aims & Objectives: To evaluate the comparative usefulness of pleural fluid biochemical parameters with relative usefulness of pleural cholesterol to the traditional Light’ criteria. Methodology: This observational nonrandomized multiple arm prospective study was carried out in a group of new PE cases, admitted between December 2015 to September 2017 in the Department of Medicine at Gajra Raja Medical College, Gwalior, India. A total of 100 adult patients of both gender were selected by adhering strictly to certain inclusion and exclusion criteria.Statistical Analysis : Sensitivity, specificity, positive predictive value and negative predictive value of different biochemical parameters single or in combination were analyzed by SPSS 19 software. Strict confidentiality of the study reports was maintained and all the queries and apprehensions of the patients and their families were addressed with utmost care. Prior to initiating the study, counselling of the patients and their families were done and an informed written consent was taken. Results: According to their etiology, 88 cases of effusion were exudates & 12 transudates. Using Pleural Cholesterol range of 45-60 mg/dl and values for pleural fluid protein & LDH (Light’s criteria),the best diagnostic power corresponded to the combination of pleural cholesterol and LDH; cholesterol level between 45-60 mg/dL and/or LDH over 200 IU/L differentiate exudates from transudates with a sensitivity o and a specificity of >90%. Conclusion : The measurement of pleural cholesterol and LDH permits the separation of pleural exudates from transudates with accuracy similar to the original report of Light et al., with the advantage of requiring only two laboratory determinations and no simultaneous blood sample, especially in a country like India where financial and technical constraints are immense.
Authors and Affiliations
Shah N1 . . , Trikha S1 . . , Jatav , O. P1, Shah R2 . . , Singh N . . , Rajput S1 . .
Keywords
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