Retrospective Analysis of 240 Cases with Pleural Effusion

Objective: Pleural effusion (PE) takes an important place in the clinical practice of thoracic diseases because of the difficulties in establishing an etiological diagnosis. The causes of effusion differ depending on the region where the examination is carried out, the clinic and the population involved. In this study, we aimed to evaluate adult patients who were examined due to PE in our clinic at a specific hospital for chest diseases.
Methods: The recordings of 240 patients who were hospitalised between June 2010 and July 2013 in our clinic and examined due to PE were retrospectively evaluated. Their fluid samples were taken and the patients were exposed to advanced invasive procedures when necessary. Demographic features of the patients, fluid analyses, diagnostic methods and diagnoses were reviewed.
Results: Of the cases, 68% were male. The mean age was 58±20 years and the most common complaint for admission was shortness of breath. The amount of pleural fluid was moderate in 56% of the cases. Eighty seven percent of the fluids were exudative. The concentration of glucose was below 60 mg/dL in 40 patients and the concentration of adenosine deaminase was above 40 U/L in 39 patients. The diagnosis of tuberculosis (TB) pleurisy was established to a great extent. Of the invasive procedures, closed pleural biopsy and fiberoptic bronchoscopy contributed to the diagnosis at rates of 47% and 21%, respectively. Of 61 malignancy-induced PEs, 38 were due to primary lung cancer and 8 were due to malignant mesothelioma. Apart from mesothelioma, 66% of these effusions were malignant effusions and contribution of the initial thoracentesis to this diagnosis was found to be 40%.
Conclusion: In our serial study, the most common causes of PE was TB in female patients, and pneumonia in male patients. Invasive procedures except thoracentesis were performed for 160 cases in total in the study. In 10 cases, the etiology of effusion could not be identified.