Clinico-epidemiological profile and short-term outcomes of patients with metastatic malignant pleural effusion in Baghdad, Iraq

Objectives: To describe the epidemiological profile of metastatic malignant pleural effusion (MPE) in patients admitted to the surgical wards at a tertiary hospital in Baghdad, Iraq. Methodology: The study was single-center, cross-sectional, and comprised 90 successive patients who were hospitalized with MPE. Results: Out of 90 patients, 60% were females and the age group 46-55 years formed the highest percentage (33.3%). We found that 97.8% had pre-existing malignancy, mainly breast cancer and 85.5% suffered non-specific generalized symptoms related to the primary malignancy. All the cases presented with shortness of breath, cough, and chest pain, and only 3.3% were asymptomatic. Pleurodesis was done in 84 patients and in the majority of them (86.7%) bleomycin was used. The majority of the pleural fluid aspirates were exudate according to Light criteria. 40% patients improved during hospitalization. Better improvement was observed among unilateral, and small MPE. Less than one-third of the cases had recurrent effusion, which was mostly in those with bilateral and secondary MPE. The survival rate was relatively good (82%). Around 6% cases were referred to oncologists. Conclusion: Although the therapeutic approaches of MPE were mostly palliative not curative, a substantial improvement in outcome after the management of MPE was noted. Parameters that predict favorable short-term outcomes are unilateral and small pleural effusions.