DUETS for Light's in separating exudate from transudate.

IF 6.6 2区 医学 Q1 RESPIRATORY SYSTEM
Respirology Pub Date : 2024-11-01 Epub Date: 2024-07-03 DOI:10.1111/resp.14780
Astrid Gardiner, Ryan Ling, Yiong-Huak Chan, Jose Porcel, Y C Gary Lee, Chia-Meng Teoh, Mei-Fong Liew, Jeevesh Kapur, Seow-Ping Low, Pyng Lee
{"title":"DUETS for Light's in separating exudate from transudate.","authors":"Astrid Gardiner, Ryan Ling, Yiong-Huak Chan, Jose Porcel, Y C Gary Lee, Chia-Meng Teoh, Mei-Fong Liew, Jeevesh Kapur, Seow-Ping Low, Pyng Lee","doi":"10.1111/resp.14780","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Fifty years since its inception, Light's criteria have aided in classifying pleural effusions (PEs) as exudates if 1 or more criteria are met. Thoracic ultrasound (US) emerges as a non-invasive technique for point of care use especially if pleural procedures are contemplated.</p><p><strong>Objective: </strong>We aimed to develop a score based on radiological and US features that could separate exudates from transudates without serum and pleural fluid biochemical tests necessary for Light's criteria.</p><p><strong>Methods: </strong>A prospective review of consecutive patients with PE who underwent thoracocentesis was performed. CXRs were evaluated for laterality followed by US for echogenicity, pleural nodularity, thickening and septations. PE was classified as exudate or transudate according to Light's criteria and corroborated with albumin gradient. A score combining radiological and US features was developed.</p><p><strong>Results: </strong>We recruited 201 patients with PE requiring thoracocentesis. Mean age was 64 years, 51% were females, 164 (81.6%) were exudates, and 37 (18.4%) were transudates. Assigning 1-point for Diaphragmatic nodularity, Unilateral, Echogenicity, Pleural Thickening and Septations, DUETS ranged from 1 to 5. DUETS ≥2 indicated high likelihood for exudate (PPV 98.8%, NPV 100%) with 1% misclassification versus 6.9% using Light's criteria (p < 0.001).</p><p><strong>Conclusion: </strong>DUETS separated exudates from transudates with good accuracy, and could obviate paired serum and pleural fluid tests necessary for Light's criteria computation. Our study reflected real world practice where DUETS performed better than Light's criteria for PE that arose from more than one disease processes, and in the evaluation of patients with PE who have received diuretics.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/resp.14780","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Fifty years since its inception, Light's criteria have aided in classifying pleural effusions (PEs) as exudates if 1 or more criteria are met. Thoracic ultrasound (US) emerges as a non-invasive technique for point of care use especially if pleural procedures are contemplated.

Objective: We aimed to develop a score based on radiological and US features that could separate exudates from transudates without serum and pleural fluid biochemical tests necessary for Light's criteria.

Methods: A prospective review of consecutive patients with PE who underwent thoracocentesis was performed. CXRs were evaluated for laterality followed by US for echogenicity, pleural nodularity, thickening and septations. PE was classified as exudate or transudate according to Light's criteria and corroborated with albumin gradient. A score combining radiological and US features was developed.

Results: We recruited 201 patients with PE requiring thoracocentesis. Mean age was 64 years, 51% were females, 164 (81.6%) were exudates, and 37 (18.4%) were transudates. Assigning 1-point for Diaphragmatic nodularity, Unilateral, Echogenicity, Pleural Thickening and Septations, DUETS ranged from 1 to 5. DUETS ≥2 indicated high likelihood for exudate (PPV 98.8%, NPV 100%) with 1% misclassification versus 6.9% using Light's criteria (p < 0.001).

Conclusion: DUETS separated exudates from transudates with good accuracy, and could obviate paired serum and pleural fluid tests necessary for Light's criteria computation. Our study reflected real world practice where DUETS performed better than Light's criteria for PE that arose from more than one disease processes, and in the evaluation of patients with PE who have received diuretics.

DUETS 用于分离渗出液和渗出液。
背景:Light标准自提出以来已有50年,它有助于将符合1个或多个标准的胸腔积液(PE)归类为渗出液。胸腔超声(US)作为一种非侵入性技术出现,可用于医疗点,尤其是在考虑进行胸膜手术时:我们的目的是根据放射学和 US 的特征制定一个评分标准,该评分标准无需进行 Light 标准所需的血清和胸腔积液生化检查即可区分渗出液和透出液:方法:对连续接受胸腔穿刺术的 PE 患者进行前瞻性复查。方法:对连续接受胸腔穿刺术的 PE 患者进行前瞻性复查,评估胸廓侧位,然后用超声波检查回声、胸膜结节、增厚和隔膜。根据 Light 标准将 PE 分为渗出型和透出型,并通过白蛋白梯度进行确证。结果:我们招募了 201 名需要进行胸腔穿刺术的 PE 患者。平均年龄为 64 岁,51% 为女性,164 例(81.6%)为渗出型,37 例(18.4%)为透出型。膈肌结节、单侧、回声、胸膜增厚和胸膜裂开为 1 分,DUETS 为 1 至 5 分。DUETS≥2 表示渗出的可能性很高(PPV 98.8%,NPV 100%),误诊率为 1%,而使用 Light 标准的误诊率为 6.9%(P 结论:DUETS ≥2 表示渗出的可能性很高(PPV 98.8%,NPV 100%),而使用 Light 标准的误诊率为 6.9%:DUETS 能准确地将渗出液和透出液区分开来,并能省去计算 Light 标准所需的血清和胸腔积液配对检测。我们的研究反映了真实世界的实践,在评估由多种疾病过程引起的 PE 以及接受利尿剂治疗的 PE 患者时,DUETS 的表现优于 Light 标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Respirology
Respirology 医学-呼吸系统
CiteScore
10.60
自引率
5.80%
发文量
225
审稿时长
1 months
期刊介绍: Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信