Abstract
Background: It is known that malignant pleural effusion (MPE), especially from lung cancer, heralds an overall poor prognosis. In addition to the human cost of distress and morbidity, it is also recognized to be a rapidly rising healthcare burden. There has been renewed interest in comparing chemical pleurodesis with indwelling pleural catheter (IPC). Hospital length of stay (LOS) and complications of chemical pleurodesis were frequently cited disadvantages compared with IPC.
Methods: We conducted a retrospective review of talc pleurodesis performed for MPE between 1st Jul 2011 - 31st Dec 2013, with emphasis on 1. Efficacy (defined by clinic-radiological success till death) 2. LOS and LOS-effusion related 3. Talc-related complications. The patients were identified using pharmacy's records of talc prescribed on electronic IMR with confirmed or strongly suspected MPE.
Results: Medical records of 120 patients were analysed, of which 1 patient had bilateral talc pleurodesis during the same hospitalization. 77(63.6%) were primary lung cancer. 69(73%) had successful talc pleurodesis with an overall median survival of 5 months. The median LOS and LOS-effusion related were 16 and 13 days respectively. Talc-related complications were fever: 66(57.9%), pain: 48(43.2%), arrythmias: 21(18.6%), hypoxaemia: 16(14%), pleural infection: 1(0.8%). 21% of patients with fever had unscheduled venepunctures for blood cultures and 35% were prescribed antibiotics.
Conclusion: The extended LOS was mainly attributed to 2 factors: 1) Days required for complete drainage of effusion before talc pleurodesis was performed; 2) Days for the completion of intravenous(IV) antibiotics for post-talc fever. There were also more fever and hypoxaemia as compared to previous studies.
- Copyright ©the authors 2016
