Accuracy of Uric Acid and Cholesterol Levels Examination in Distinguishing Pleural Effusion Fluid Exudates and Transudates

Background: Light's criteria was reported 25% of misclassification transudates as exu­dates. This study aimed to analyse the accuracy of examining uric acid levels and pleural fluid uric acid levels, and pleural fluid cholesterol and cholesterol ratios to distinguish the exudates and transudates in pleural effusions. Subjects and Method: This was a cross-sectional study de­sign conducted at Dr. Moe­wardi Hospital, Surakarta, Central Java, from July to August 2019. The study subjects were 30 pleural effusion patients treated in the pul­monology ward. The dependent variables were pleural fluid exudates and transudates. The indepen­dent variables were (1) Uric acid levels in pleu­ral fluid; (2) The ratio of uric acid levels be­tween pleural fluid and serum; (3) Pleural fluid cholesterol levels; and (4) The ratio of cho­lesterol levels between pleural fluid and serum. The study instruments were Light's cri­teria and laboratory examination. The diag­nosis's accuracy was analysed using sensi­tivi­ty, specificity, and the area under the ROC (AUC) curve. Results: Pleural fluid cholesterol showed sen­­sitivity and specificity of 86% and 83%, with a cut-off of 32.00 for transudate results. AUC value = 0.82 with p = 0.012. Serum cholesterol showed sensitivity and specificity of 71% and 61%, with a cut-off of 175.50 for transudate re­sults. AUC value = 0.67 with p = 0.194. Pleu­ral fluid uric acid levels showed a sensitivity and specificity of 86% and 87%, with a cut-off of 7.25 for transudate results. AUC value = 0.83 with p = 0.009. Examination of serum uric acid levels showed a sensitivity and specificity of 86% and 70%, with a cut-off of 7.10 for trans­udate results. AUC value = 0.65 with p = 0.249. Conclusion: Examination of uric acid and pleural fluid cholesterol levels can be used in routine pleural effusion examinations to distin­guish exudates and transudates. Keyword s : accuracy, uric acid, exudates, cho­les­te­rol, transudates Correspondence:  Yusup Subagio Sutanto. Department of Pul­mo­no­logy and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret, Dr. Moe­wardi Hospital, Surakarta. Jl. Kolonel Sutarto 132, Jebres, Surakarta 57126, Central Java. Email: dr_yusupsubagio­@yahoo.com. Mobile: +62811284165. Indonesian Journal of Medicine (2021), 06(02): 159-167 https://doi.org/10.26911/theijmed.2021.06.02.05