Assessing Factors That May Impact Physician-based Decisions for Placing Indwelling Pleural Catheters.

IF 3.3 Q2 RESPIRATORY SYSTEM Journal of Bronchology & Interventional Pulmonology Pub Date : 2024-01-01 DOI:10.1097/LBR.0000000000000926

Matthew Alexander, Yoshiko Ishisaka, Lina Miyakawa, Adam Rothman

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Abstract

Introduction: Malignant pleural effusion is a common finding in patients with advanced cancer and is a frequent cause of dyspnea. Current guidelines indicate thoracentesis for symptomatic patients, while indwelling pleural catheters (IPC) are recommended for patients who develop pleural fluid re-accumulation. IPC maintenance, however, requires a significant level of financial and social support. This study aims to analyze potential influencing factors that may play a role in the decision for placing IPCs in patients with recurrent malignant pleural effusions.

Methods: This study retrospectively collected baseline sociodemographic and laboratory data in patients who underwent thoracentesis for malignant pleural effusion from August 2016 to October 2021, and selected patients who presented with re-accumulation of pleural fluid within 30 days or had a pulmonary physician's note documenting that IPC is a potential management option. Of these selected patients (IPC candidates), we stratified patients who underwent IPC placement and those who did not, and performed statistical analysis between these 2 groups.

Results: One hundred seventy-six patients who underwent thoracentesis were regarded as IPC candidates. Almost all baseline sociodemographic characteristics, including ethnicity ( P =0.637), sex ( P =0.655), and marital status ( P =0.773) were similar between the 2 groups, but significantly higher ECOG scores ( P =0.049) were noted in the IPC group. No statistically significant differences were noted in age, body mass index, platelet, PTT, international normalized ratio, creatinine, white blood cell, red blood cells, fluid protein, or fluid lactate dehydrogenase. Fluid albumin ( P =0.057) and serum neutrophil:lymphocyte ratio ( P =0.003) were significantly higher in patients without IPC placement.

Conclusion: This study did not recognize any baseline sociodemographic factors that may contribute to the decision to place IPCs.

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评估可能影响医生决定放置留置胸膜导管的因素。

简介：恶性胸腔积液是晚期癌症患者的常见病，也是呼吸困难的常见原因。现行指南建议对有症状的患者进行胸腔穿刺术，而对出现胸腔积液再次积聚的患者则建议使用留置胸膜导管（IPC）。然而，IPC 的维护需要大量的经济和社会支持。本研究旨在分析可能影响复发性恶性胸腔积液患者决定置入 IPC 的潜在因素：本研究回顾性地收集了2016年8月至2021年10月期间因恶性胸腔积液而接受胸腔穿刺术的患者的基线社会人口学和实验室数据，并选择了在30天内出现胸腔积液再次积聚或有肺科医生记录IPC是一种潜在治疗方案的患者。在这些入选患者（IPC 候选者）中，我们对接受 IPC 置入术和未接受 IPC 置入术的患者进行了分层，并对这两组患者进行了统计分析：结果：176 名接受了胸腔穿刺术的患者被视为 IPC 候选者。两组患者几乎所有的基线社会人口学特征，包括种族（P =0.637）、性别（P =0.655）和婚姻状况（P =0.773）都相似，但 IPC 组的 ECOG 评分明显更高（P =0.049）。年龄、体重指数、血小板、PTT、国际标准化比值、肌酐、白细胞、红细胞、体液蛋白或体液乳酸脱氢酶在统计学上无明显差异。未置入 IPC 的患者的体液白蛋白（P =0.057）和血清中性粒细胞与淋巴细胞比值（P =0.003）明显更高：本研究未发现任何基线社会人口学因素可能会影响放置 IPC 的决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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