PT  - JOURNAL ARTICLE
AU  - Richard Budd
AU  - Nanu Acharya
AU  - Muhammad Malik
TI  - The impact of malignant pleural effusion – A retrospective review
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2839
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2839.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2839.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Barnsley Hospital (BH) serves a population of 220,000 people. The respiratory specialists have noticed a high burden of care associated with the management of pleural disease. An average United Kingdom (UK) district general hospital would expect to diagnose and treat approximately 250 new cases of malignant pleural effusion (MPE) per year [1]. Projected figures suggest an increase of 100,000 cancer diagnoses per year within the UK of which 15% will have an associated MPE [1]. One NHS bed day costs £225 [2] and with this in mind we considered the workload and financial resources required to manage these cases.Method: We retrospectively analysed data over an 18-month period, searching clinical coding archives using the keyword “pleural effusion”. Cases with a malignancy coded under the heading “primary diagnosis”, “diagnosis 1” or “diagnosis 2” were identified as having a MPE. These cases were reviewed to assess total number of inpatient days, number of patient episodes and length of stay (LOS).Results: Number of patient episodes for pleural effusion of any cause = 1195Number of patient episodes for MPE = 226 (including recurrent admissions)Number of MPE secondary to lung cancer = 90 (39.8%)Average LOS for MPE = 7.3 daysConclusion: The burden of MPE management at BH is significant, considering that in this 18 month period 1650 inpatient days were utilised.By highlighting the financial impact of this data there has been a successful bid by the lead lung cancer specialist for funding of a medical thoracoscopy service in BH. A recent audit of the medical thoracoscopy service has confirmed a reduction in LOS and recurrent admissions.Reference:1. British Thoracic Society Pleural Disease Guidelines 2010.2. http://www.institute.nhs.uk/.