Epidemiology of Adult Pleural Disease in the United States

Mummadi, Srinivas R.; Stoller, James K.; López, Rocío; Kailasam, Karthik; Gillespie, Colin T.; Hahn, Peter Y.

doi:10.1016/j.chest.2021.05.026

Cited by 52 publications

(61 citation statements)

References 39 publications

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“…PE is a common clinical manifestation caused by more than 50 diseases. Tuberculosis, pneumonia, and malignancy are among the most common causes of PE ( 2 , 3 , 11 ). In recent years, patients with BPE, such as TPE and PPE, can be clinically cured due to advances in treatment regimens and early diagnosis ( 2 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pleural effusion (PE) is a common clinical problem resulting from increased fluid in the pleural cavity ( 1 , 2 ). The various etiologies of PE can be divided into benign pleural effusion (BPE) and malignant pleural effusion (MPE) ( 3 ). In China, the majority of BPE arises from tuberculous pleural effusion (TPE), parapneumonic effusion (PPE), and heart failure (HF) ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Liang

Yuan

et al. 2021

Front. Oncol.

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BackgroundThe diagnostic value of clinical and laboratory features to differentiate between malignant pleural effusion (MPE) and benign pleural effusion (BPE) has not yet been established.ObjectivesThe present study aimed to develop and validate the diagnostic accuracy of a scoring system based on a nomogram to distinguish MPE from BPE.MethodsA total of 1,239 eligible patients with PE were recruited in this study and randomly divided into a training set and an internal validation set at a ratio of 7:3. Logistic regression analysis was performed in the training set, and a nomogram was developed using selected predictors. The diagnostic accuracy of an innovative scoring system based on the nomogram was established and validated in the training, internal validation, and external validation sets (n = 217). The discriminatory power and the calibration and clinical values of the prediction model were evaluated.ResultsSeven variables [effusion carcinoembryonic antigen (CEA), effusion adenosine deaminase (ADA), erythrocyte sedimentation rate (ESR), PE/serum CEA ratio (CEA ratio), effusion carbohydrate antigen 19-9 (CA19-9), effusion cytokeratin 19 fragment (CYFRA 21-1), and serum lactate dehydrogenase (LDH)/effusion ADA ratio (cancer ratio, CR)] were validated and used to develop a nomogram. The prediction model showed both good discrimination and calibration capabilities for all sets. A scoring system was established based on the nomogram scores to distinguish MPE from BPE. The scoring system showed favorable diagnostic performance in the training set [area under the curve (AUC) = 0.955, 95% confidence interval (CI) = 0.942–0.968], the internal validation set (AUC = 0.952, 95% CI = 0.932–0.973), and the external validation set (AUC = 0.973, 95% CI = 0.956–0.990). In addition, the scoring system achieved satisfactory discriminative abilities at separating lung cancer-associated MPE from tuberculous pleurisy effusion (TPE) in the combined training and validation sets.ConclusionsThe present study developed and validated a scoring system based on seven parameters. The scoring system exhibited a reliable diagnostic performance in distinguishing MPE from BPE and might guide clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Liang

Yuan

et al. 2021

Front. Oncol.

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“…On the other hand, non-malignant etiologies explain most pleural effusions and understanding the key events of benign pleural pathologies is important to better treat these patients [7]. The annual hospitalization rate showed a significant decrease in malignant pleural effusion and pleural tuberculosis, but an increase for nonmalignant pleural effusion in the United States, with empyema showing the higher costs and length of stay [8]. Despite nonmalignant, benign pleural effusions can be associated with poor patients' survival.…”

Section: Introductionmentioning

confidence: 99%

Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology

Karpathiou

Péoc’h

Sundaralingam

et al. 2022

Cancers

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Pleural effusions are a common respiratory condition with many etiologies. Nonmalignant etiologies explain most pleural effusions and despite being nonmalignant, they can be associated with poor survival; thus, it is important to understand their pathophysiology. Furthermore, diagnosing a benign pleural pathology always harbors the uncertainty of a false-negative diagnosis for physicians and pathologists, especially for the group of non-specific pleuritis. This review aims to present the role of the inflammation in the development of benign pleural effusions, with a special interest in their pathophysiology and their association with malignancy.

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“…Epidemiological studies suggest that the incidence of any pleural disease is increasing 2 3. The increase in cancer diagnoses and the increased longevity of those afflicted with cancer have caused an increase in the incidence of malignant pleural effusion (MPE) and IPCs have a crucial role to play in the management of MPE.…”

Section: Introductionmentioning

confidence: 99%

Indwelling pleural catheters: evidence for and management

Davidson

Carling

Jackson

et al. 2022

Postgraduate Medical Journal

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The incidence of pleural disease is increasing, and pleural medicine is increasingly recognised as a subspecialty within respiratory medicine. This often requires additional training time. Once underresearched, the last decade has seen an explosion in evidence related to the management of pleural disease. One of the cornerstones of pleural effusion management is the insertion of an indwelling pleural catheter. This allows patient-centred outpatient management and now has a robust evidence base. This article summarises evidence as well serves as a practical guide to the management of any complications related to an indwelling pleural catheter that might present on an acute take.

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Epidemiology of Adult Pleural Disease in the United States

Cited by 52 publications

References 39 publications

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology

Indwelling pleural catheters: evidence for and management

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