Photo Credit: Sopone Nawoot

The following is a summary of “Predictors of lung entrapment in malignant pleural effusion,” published in the November 2024 issue of Pulmonology by Trovisco et al. 

Researchers conducted a retrospective study to analyze the risk factors for malignant non-expandable lung (NEL) in patients with malignant pleural effusion (MPE).  

They analyzed patients diagnosed with pathologically confirmed MPE between January 2012 and December 2018. Demographic and clinical data were reviewed and compared based on the presence or absence of NEL. Univariate and multivariate binary logistic regression analyses were performed to identify predictors of NEL development.  

The results showed that of 365 patients, 68 (18.6%) had NEL. Multivariate analysis identified loculated MPE (OR 8.63, 95%CI 4.30-17.33, P <0.001), complete hemithorax opacification (OR 2.81, 95%CI 1.17-6.76, P <0.021), lung cancer (OR 2.09, 95%CI 1.01-4.31, P =0.047), and higher effusion-serum lactate dehydrogenase (LDH) ratio (OR 1.09, 95%CI 1.00-1.17, P =0.039) as independent predictors of malignant NEL. No substantial differences were seen in the time from primary malignancy diagnosis to MPE diagnosis (P =0.942) or from MPE symptom onset to MPE diagnosis (P =0.497). Patients with NEL required more pleural drainages (3.0, IQR 2.0-6.0 vs 2.0, IQR 1.0-3.0, P <0.001) and had longer hospital stays (32.5, IQR 15.5-46.3 vs 21.0, IQR 11.0-36.0, P =0.007). No significant difference was noted in pleural effusion recurrence (P =0.291). Overall survival (OS) was 3.0 months (95%CI 2.3-3.7), regardless of lung expandability (P =0.923).  

Investigators concluded the loculated MPE, complete hemithorax opacification, lung cancer, and a higher effusion-serum LDH ratio were independent predictors of NEL, associated with more frequent thoracenteses and longer hospital stays, but without significant impact on OS. 

Source: sciencedirect.com/science/article/pii/S2531043722001994