STUDY OF THE CLINNICAL CHARACTERISTICS AND OUTCOMES OF EXUDATIVE PLEURAL EFFUSION: IMPROVING CLINICAL DECISION MAKING IN RESOURCE LIMITED SETTING

Authors

  • Deebya Raj Mishra Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan
  • N Bhatta Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan
  • P Koirala Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan
  • RH Ghimire Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan
  • B Bista Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan
  • N Shah Department of Pathology, B. P. Koirala Institute of Health Sciences, Dharan

DOI:

https://doi.org/10.3126/saarctb.v14i1.17727

Keywords:

Exudative Pleural Effusion, Tuberculosis, Clinical Decision Making

Abstract

Introduction: In the background of resource limited setting like Nepal, we set out to identify if specific clinical characteristics and basic lab parameters would guide differentiation of Tuberculous from other causes of exudative pleural effusion.

Methodology: Retrospective study of 109 consecutive patients with exudative pleural effusion.

Results: Compared to Tubercular pleural effusions (41.3%), increased age, increased duration of symptom and increased pack years statistically favoured a diagnosis of Malignant pleural effusion(21.1%), whereas presence of fever, cough and increased pleural ADA levels favoured Tubercular pleural effusions. With regards to Parapneumonic effusions (26.6%), a shorter duration of symptom, smaller effusions, higher pleural Neutrophils, lower pleural lymphocyte neutrophil ratio and lower ADA favoured the diagnosis as compared to Tubercular pleural effusions.

Conclusions: The appreciation of important clinical and pleural biochemical differences between Tubercular and other major causes of exudative pleural effusions aids in improved clinical decision making with minimal resources in resource limited settings like ours.

SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), page: 33-39

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Published

2017-07-12

How to Cite

Mishra, D. R., Bhatta, N., Koirala, P., Ghimire, R., Bista, B., & Shah, N. (2017). STUDY OF THE CLINNICAL CHARACTERISTICS AND OUTCOMES OF EXUDATIVE PLEURAL EFFUSION: IMPROVING CLINICAL DECISION MAKING IN RESOURCE LIMITED SETTING. SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, 14(1), 33–39. https://doi.org/10.3126/saarctb.v14i1.17727

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