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Disorders of the Pleura |

Light Criteria Can Be Modified? FREE TO VIEW

Carolina Gotera, MD; Deisy Barrios Barreto, MD; Patricia Lazo Meneses, MD; Rosa Mirambeaux Villalona, MD; Carolina Jurkojc Mohremberger, MD; Esteban Perez Rodriguez, PhD; Salvador Diaz Lobato, PhD; Sagrario Mayoralas Alises, PhD
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Ramon y Cajal Hospital, Madrid, Spain


Chest. 2014;145(3_MeetingAbstracts):277A. doi:10.1378/chest.1823882
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Abstract

SESSION TITLE: Pleural Disease/Pleural Effusion Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To find biochemical parameters in pleural fluid, that may exceed the performance of Light criteria to discriminate transudates and exudates. Assess whether the clinical diagnosis exceeds or not biochemical parameters of pleural fluid to differentiate transudates and exudates.

METHODS: From 1994 to October 2011, 2413 consecutive pleural effusions (PE) were studied, following the protocol of the pleura unit and were included in our database. All cases were closed with a final diagnosis according to results of pleural fluid, pleural biopsy, treatment response and outcome. Of these 301 (12.8‰) were transudates and 2098 (89.8‰) exudates. All cases received pretest diagnosis by two observers and were analysed the following biochemical parameters like Proteins, LDH, Cholesterol, Triglycerides, albumin and ADA level in pleural fluid and serum. The statistical analysis was descriptive means, standard deviations, applying Mann Whitney test.

RESULTS: 301 were transudate, 111 women and 190 men, with a mean age of 71.16 ±12.2. 2098 were exudates, 1324 men and 774 women, with a mean age of 64.19± 17.08. The criteria analyzed gave similar results, observing the high sensitivity and specificity of pretest diagnosis (sensitivity 95,9‰ and specificity 67,5‰) with results equal or superior to the Lights criteria.

CONCLUSIONS: The clinical diagnosis provides similar sensitivity and specificity that Lights Criteria for discriminating transudates and exudates The association of biochemical parameters of pleural fluid combined with pretest diagnosis provides equal or better performance than the Lights Criteria without simultaneous serum analysis, specially the ADA level in pleural fluid with pretest diagnosis.

CLINICAL IMPLICATIONS: Our findings show that the combination of pre-test diagnostics with pleural fluid parameters provide better values of light criteria without serum analisis, which frequently are altered by the use of diuretics.

DISCLOSURE: The following authors have nothing to disclose: Carolina Gotera, Deisy Barrios Barreto, Patricia Lazo Meneses, Rosa Mirambeaux Villalona, Carolina Jurkojc Mohremberger, Esteban Perez Rodriguez, Salvador Diaz Lobato, Sagrario Mayoralas Alises

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