Chest
Clinical InvestigationsPLEURAL DISEASEPleural Fluid pH as a Predictor of Survival for Patients With Malignant Pleural Effusions
Section snippets
Materials and Methods
The study was approved by the Institutional Review Board for Human Research of the Medical University of South Carolina. Pertinent articles that contained data on pH and survival for patients with malignant pleural effusions were identified by a MEDLINE search that used the following search terms: pH, PF, pleural effusions, pleural malignancy, malignant effusions, and pleurodesis. Articles in the authors’ files and references of retrieved articles were also reviewed. Retrieved articles were
Data Sources
The search identified nine sources with available data 1, 47, 1516, 1718, 19, 20 reported by seven primary investigators and one unpublished data set (F. Rodriguez-Panadero, MD, personal communication). An additional study that reported PF pH and survival in 131 patients with malignant effusions was identified, but the primary investigator stated that the primary data were no longer available.21
The data sources contained information on PF pH collected from 417 patients. We previously reported
Discussion
Our analysis of individual patient-level data demonstrates that PF pH has limited clinical utility for selecting patients for pleurodesis on the basis of predicted survival. Among the patient characteristics available for analysis, only pH and tumor type were independent predictors of poor short-term survival. Patients with a pH ≤ 7.28 had a 3-month survival of 38.9% compared with 61.6% for patients with a pH > 7.28. Although pH was a significant predictor of duration of survival and calibrated
ACKNOWLEDGMENTS
The authors thank the investigators who performed the primary investigations for providing their patient-level data. We also thank Drs. Steven A. Sahn and Marc Silverstein for reviewing the manuscript.
References (26)
- et al.
Pleural fluid analysis in malignant mesothelioma: prognostic implications
Chest
(1991) - et al.
Thoracoscopic talc poudrage in malignant pleural effusions: effective pleurodesis despite low pleural pH
Chest
(1998) Evaluating diagnostic tests in the pleural space: differentiating transudates from exudates as a model
Clin Chest Med
(1998)- et al.
Pleural fluid pH in malignant effusions: diagnostic, prognostic, and therapeutic implications
Ann Intern Med
(1988) - et al.
Low glucose and pH levels in malignant pleural effusions: diagnostic significance and prognostic value in respect to pleurodesis
Am Rev Respir Dis
(1989) - et al.
Survival time of patients with pleural metastatic carcinoma predicted by glucose and pH studies
Chest
(1989) - et al.
Survival and talc pleurodesis in metastatic pleural carcinoma revisited: report of 125 cases
Chest
(1993) - et al.
The pathogenesis of low glucose, low pH malignant effusions
Am Rev Respir Dis
(1985) Pleurodesis for malignant and nonmalignant pleural effusions
Clin Pulm Med
(1999)- et al.
Malignant pleural effusions: meaning of pleural-fluid pH determination
Oncology
(1990)
Predicting clinical states in individual patients
Ann Intern Med
Users' guide to the medical literature: V. How to use an article about prognosis; Evidence-Based Medicine Working Group
JAMA
Clinical epidemiology: the essentials
Cited by (156)
LENT Score: Predicting the Survival of Malignant Pleural Effusion – A Prospective Study of Three Years
2020, Archivos de BronconeumologiaMalignancy-Related Effusions
2019, Abeloff’s Clinical Oncology