COMPARISON OF LIGHT’S CRITERIA AND PLEURAL FLUID CHOLESTEROL TO DISTINGUISH EXUDATIVE AND TRANSUDATIVE PLEURAL FLUID
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 38
Abstract
BACKGROUND Light’s criteria is the gold standard to differentiate transudative pleural effusion from exudative pleural effusion, but it requires four biochemical estimations which in developing countries such as India, may not be feasible in every patient due to economic constraints. MATERIALS AND METHODS In this prospective study, 60 patients with pleural effusion were included. Pleural fluid total protein, LDH and cholesterol as well as serum total protein and LDH levels along with other investigations were studied. Clinical classification of transudate or exudate was done based on aetiology. RESULTS Based on clinical signs and symptoms, chest radiograph and other investigations, 52 of these effusions were classified as exudates and 8 as transudates. Using the pleural fluid cholesterol cut-off point >45 mg/dL to differentiate exudates and transudates, the sensitivity, specificity, positive predictive value (PPV) and the negative predictive value (NPV) were found to be 100%. Using Light’s criteria to differentiate exudates and transudates, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were found to be 98%, 87.5%, 98% and 87.5% respectively. The differences resulted from misclassification of 1 expected exudate as transudate out of 52 and 1 expected transudate as exudate out of 8 by Light’s criteria. CONCLUSION Pleural fluid cholesterol is a simple, cost effective and useful parameter in differentiating pleural exudates from transudates, with the advantage of requiring only one laboratory determination and no simultaneous blood sample, as compared to the use of Light’s criteria.
Authors and Affiliations
Kali Gandhi, Uday Raj Singh, Kol P. C, Ashutosh Garg, Krati Gandhi, Sutrakar S. K, Hemlata Bamoriya
Keywords
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- EP ID EP212894
- DOI 10.14260/Jemds/2017/659
- Views 103
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