PLEURAL FLUID TO SERUM PSUEDOCHOLINESTERASE RATIO AND ITS VALIDATION WITH LIGHT’S CRITERIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2014, Vol 3, Issue 1
Abstract
[b] BACKGROUND AND OBJECTIVES:[/b] Pleural effusion is a common clinical condition faced in everyday practice. The first step in the management of pleural effusion is its differentiation into transudates and exudates.Light’s criteria is the most widely used parameter to differentiate pleural effusions but studies have shown that Light’s criteria misclassifies a significant number of cases. This study was carried out to analyze the levels of pseudocholinesterase (ChE) in various types of pleural effusions and comparing ChE levels and the pleural fluid to serum ratio of ChE with Light’s criteria to differentiate between transudates and exudates. [b]METHODS[/b]:This study was conducted at Victoria Hospital and Bowring & Lady Curzon Hospitals attached to Bangalore Medical College and Research Institute. Study included 62 patients with pleural effusion, who met the inclusion and exclusion criteria. Duration of the study was 18months.[b]RESULTS[/b]:31 cases (50%) had transudative effusion and 31 cases (50%) had exudative effusion. The mean PChE levels in transudate was 385+142U/L and in case of exudates it was 2074+660U/L. The difference between the two groups was statistically significant (p=<0.001). The average value of pleural fluid to serum ratio of PChE was 0.09+0.05 among transudates and among exudates it was 0.58+0.12. This difference was found to be statistically significant (p=<<0.001). The ratio misclassified only 1 case of pleural effusion among the analyzed 62 cases. The sensitivity of the ratio was 100% and specificity was 96.7% whereas, the Light’s criteria misclassified 3 cases of pleural effusion (4.8%) with a sensitivity of 93% and specificity of 96%. [b]CONCLUSION: [/b]Light’s criteria has a good sensitivity and specificity, but pleural fluid to serum psuedocholinesterase ratio was the most efficient parameter in differentiating between transudates and exudates with a sensitivity of 100% and specificity of 96.7%
Authors and Affiliations
Prakash Gowdaiah, Amrutha Avati, Priya Bhate, Akkamahadevi Nippanal
Keywords
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- EP ID EP106361
- DOI 10.14260/jemds/1799
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