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Purpose: Each year in the US approximately 1.5 million people are diagnosed with pleural effusion and 178,000 thoracenteses are performed. CHF is the number one etiology. Often, the IR service is burdened by performing several thoracenteses for these patients, which takes away time and resources from performing other more advanced and efficacious procedures. Length of stay (LOS) is an important hospital metric. The literature suggests that thoracenteses do not provide a mortality benefit long term and the data is inconclusive about a short-term benefit. We investigated the shortterm effect of thoracentesis for pleural effusion secondary to CHF exacerbation. Materials: All patients admitted to the hospital at our institution between January 1, 2014, and December 31, 2014 with the final coded diagnosis of heart failure (diastolic, systolic, or combined) and who were treated medically were recorded as a control group. During the same time frame all patients admitted to the hospital with the final coded diagnosis of heart failure and who underwent thoracentesis were also recorded. Patient demographics and average LOS were retrospectively analyzed. Results: 2,822 patients with a mean age of 79.16 years were coded for a final diagnosis of heart failure without undergoing a thoracentesis during the aforementioned time period. Average LOS was calculated to be 8.43±9.79 days. Median LOS was 6 days . 92 patients with a mean age of 84.32 years and final coded diagnosis of heart failure underwent thoracentesis during this time period. Average LOS was 18.97±17.18 days. Median LOS was 13 days. Conclusions: Results from our institution suggest that there is no short-term benefit from performing inpatient thoracentesis in terms of hospital LOS and should be reserved as only to provide symptomatic relief. Despite this we have seen an increase in consults for thoracentesis in this patient group. Further correlation of LOS stratified by bilateral vs. unilateral thoracentesis and patient age are currently ongoing. In addition we are investigating if there is a role for tunneled pleural catheters in these patients so they can continuously drain on an outpatient basis and whether this can prevent admission.

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