Malignant pleural effusions (MPE) are a common complication of advanced malignancy, but little is known regarding their prevalence and overall burden on a population level.
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.
A weighted sample of 126,825 (0.35 %) admissions 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 (interquartile range (IQR)) age at admission was 68.0 (58.4-77.2). 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 (IQR) length of stay was 5.5 (2.7-10.1) days and the inpatient mortality rate was 11.6%. Median (IQR) hospitalization total charges were $42,376 (21,618-84,679). In the multivariate analyses, female gender, large fringe counties residential area, Medicare insurance and Elective type of admission were independently associated with a lower risk of inpatient mortality.
There is a considerable inpatient burden and high inpatient mortality associated with MPE in the United States with potential demographic, geographic and socioeconomic disparities.