Differentiating Pleural Effusions- Criteria Using Pleural Fluid Cholesterol

Dhandapani, Srinath; Reddy, Sivakumar; Rajagopalan, Rajalakshmi

doi:10.5152/ejp.2016.88597

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…However, the specificity of the total pleural fluid cholesterol assessment was 72.7%, higher than the specificity of Light's criteria (63.6%) as depicted in Table 7. Unlike the results of this research, a research conducted by Dhandapani et al, 10 using a lower cut-off value of total pleural fluid cholesterol (53 mg/dL) found that the sensitivity and specificity of total pleural fluid cholesterol in fifty-three samples were 91.2% and 94.7%, higher than the sensitivity and specificity of Light's criteria, 78.6% and 90.9%. 10…”

Section: Diagnosis N (%)contrasting

confidence: 99%

Total Cholesterol Analysis for Differentiating Exudates and Transudates in Pleural Fluids

Sutanto

Kurniawan

Mangarengi

2018

Indonesian J. Clin. Pathol. Med. Lab.

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The aimed of this study is to compare the diagnostic value of pleural fluid total cholesterol and Light’s criteria to determine exudate or transudate. The samples used in this cross-sectional study were pleural fluid specimens sent to the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of August-September 2016. Data were grouped according to the type of effusion then statistically analyzed using nonparametric Mann Whitney U-test. The result of this study showed from 55 samples, there were 22 transudates and 33 exudates. The mean total cholesterol levels of exudate is higher than transudate (p=0.006). By using cut-off value of total cholesterol pleural fluid 56 mg/dL, it had sensitivity 72.7%; specificity 78.8%; Positive Predictive Value (PPV) 81.3% and Negative Predictive Value (NPV) 69.6% while Light’s criteria had sensitivity 97%; specificity 63.6%; PPV 80% and NPV 93.3%. Pleural fluid total cholesterol level with cut-off 56 mg/dL is proposed to be used for differentiating exudate and transudate because it is easier and more simple to perform than Light’s criteria.

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Section: Diagnosis N (%)contrasting

confidence: 99%

Total Cholesterol Analysis for Differentiating Exudates and Transudates in Pleural Fluids

Sutanto

Kurniawan

Mangarengi

2018

Indonesian J. Clin. Pathol. Med. Lab.

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“…Pleural fluid cholesterol is better than Light's criteria for the differentiation of transudates and exudates and is less cumbersome as it does not require a simultaneous blood sampling. Cutoff value of pleural fluid cholesterol for differentiating transudates and exudates should be 45 mg/dl [39]. In this study, the sensitivity, specificity, positive predictive value and negative predictive value of the pleural fluid cholesterol (cut-off >45 mg/dl) were 97.06, 94.74, 97.06 and 94.74%, respectively, for identifying exudates.…”

Section: Diagnostic Clues For Exudates From Transudatesmentioning

confidence: 51%

Role of Pleural Fluid Cholesterol in Pleural Effusion

Hamal¹

2018

Cholesterol - Good, Bad and the Heart

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Pleural effusion occurs when formation and accumulation of pleural fluid exceeds its absorption. It indicates an imbalance between pleural fluid formation and its removal. Pleural fluid accumulates in settings of increased hydrostatic pressure, increased vascular permeability, decreased oncotic pressure, increased intrapleural negative pressure and decreased lymphatic drainage. On the basis of pathophysiology, pleural effusion can be transudates or exudates. It is important to establish an accurate etiological diagnosis so that the patient may be treated in a rational manner. Using Light's criteria may need other extra investigations to differentiate transudates and exudates but using pleural fluid cholesterol (pCHOL) will help to diagnose them with only the pleural fluid analysis. Moreover the albumin or protein gradient will need serum as well as the pleural fluid investigations and will have more financial burden than just investigating pleural fluid cholesterol. Pleural cholesterol is thought to be derived from degenerating cells and vascular leakage from increased permeability. Thus pleural fluid cholesterol is one of the important investigations that can distinguish exudates from transudates. Routine use of pleural fluid cholesterol for classifying pleural effusion should be encouraged to improve the accuracy, sensitivity and specificity.

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“…Seth et al also reported that there were 25% exudative pleural effusion in patients with congestive heart failure as much as. Therefore, Heffner's criteria can be used as an 4,[16][17][18] alternative.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Pleura Efusion Determination by Light's and Heffner's Cciteria

Ali

Kartini

Effendi

2019

Indonesian J. Clin. Pathol. Med. Lab.

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EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital Makassar ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation in the pleural cavity due to excessive transudation or exudation. Light’s criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications so several alternative criteria are developed, one of which is Heffner’s criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner’s criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light’s criteria obtained 3 misclassifications and Heffner’s criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light’s criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner’s criteria has sensitivity of 100 % and specificity of 86,7 %. Conclusion : Heffner’s criteria offers better sensitivity and specificity than Light’s criteria. Heffner’s criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner’s criteria, Light’s criteria, transudate, exudate, pleural effusion

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Differentiating Pleural Effusions- Criteria Using Pleural Fluid Cholesterol

Cited by 5 publications

References 4 publications

Total Cholesterol Analysis for Differentiating Exudates and Transudates in Pleural Fluids

Total Cholesterol Analysis for Differentiating Exudates and Transudates in Pleural Fluids

Role of Pleural Fluid Cholesterol in Pleural Effusion

Evaluation of Pleura Efusion Determination by Light's and Heffner's Cciteria

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