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Original Research: Disorders of the Pleura |

US Hospitalizations for Malignant Pleural Effusions: Data From the 2012 National Inpatient Sample

Niloofar Taghizadeh, PhD; Marc Fortin, MD; Alain Tremblay, MDCM
Author and Funding Information

FUNDING/SUPPORT: This work was supported by the Calgary Interventional Pulmonary Medicine Research Fund.

Division of Respiratory Medicine, University of Calgary and Alberta Thoracic Oncology Program, Calgary, AB, Canada

CORRESPONDENCE TO: Alain Tremblay, MDCM, Division of Respiratory Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, Canada, T2N 4N1


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(4):845-854. doi:10.1016/j.chest.2016.11.010
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Background  Malignant pleural effusion (MPE) is a common complication of advanced malignancy, but little is known regarding its prevalence and overall burden on a population level.

Methods  We conducted a retrospective analysis of MPE-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, Agency for Healthcare Research and Quality (HCUP-NIS 2012). Cases were included if MPE was coded as a primary or secondary diagnosis or if an unspecified pleural effusion was coded in addition to a diagnosis of cancer with either of these being the primary diagnosis.

Results  A weighted sample of 126,825 admissions (0.35%) for MPE was identified among the 36,484,846 weighted admissions included in the database in 2012. Of these admissions, 70,750 (55.8%) were for female patients. The median age at admission was 68.0 years (interquartile range [IQR]), 58.4-77.2 years). Lung (37.8%), breast (15.2%), hematologic (11.2%), GI tract (11.0%), and gynecologic (9.0%) cancers were the most common primary malignancies associated with MPE. The median length of stay was 5.5 days (IQR, 2.7-10.1 days), and the inpatient mortality rate was 11.6%. Median hospitalization total charges were $42,376 (IQR, $21,618-$84,679). In the multivariate analyses, female sex, large fringe county residential area, Medicare insurance, and elective type of admission were independently associated with a lower risk of inpatient mortality.

Conclusions  There is a considerable inpatient burden and high inpatient mortality associated with MPE in the United States, with potential demographic, geographic, and socioeconomic disparities.


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