Clinical, subclinical characteristics and treatment results of 768 patients with pleural effusion

ABSTRACT

Background: A pleural effusion is an abnormal collection of fluid in the pleural space resulting from excess fluid production or decreased absorption. It is the most common manifestation of pleural disease. Objective: To evaluate the etiological, clinical, subclinical characteristics and treatment results of patients with pleural effusions. Subjects and method: This was a retrospective, descriptive study on 768 patients with pleural effusion, who were treated in Department of Respiratory of Bach Mai Hospital, from January 2001 to October 2003. The information was taken from clinical records of patients. Results and conclusions: The causes of pleural effusion were tuberculosis 37.6%, lung cancer 23.8%, pneumonia or lung abscess 8.0%, chronic heart failure disease 7.1%, liver cirrhosis 3.5%, others causes 6.7% of cases. The patients presented with chest pain 81.6%, dyspnea 75.1%, cough 43.8%, expectoration 29.7%, and fever 54.8%, pleural effusion syndrome 92.2% of cases. On chest X-ray images, 75.3% of cases had Damoiseau curve. Pleural ultrasound demonstrated free pleural effusion in 63.8% of cases, loculated pleural effusion and pleural compartmentalization in 19.8%. Rivalta test of pleural fluid was positive in 83.7% of cases, negative in 13.7%. Malignant cells found in pleural fluid of 21.2%. Histology of pleural biopsies demonstrated malignant in 17.4% of cases; in which mesothelioma 4.0%, pleural tuberculosis 30.5%; others 52.1%. After the treatment, recovery accounted for 6.3% of cases, amelioration 58.3%, and no amelioration 37.4%. 66.9% of cases were performed therapeutic thoracocentesis, 2.7% were performed pleural lavage.