Evaluation of Pleural Effusion Type Determination Based on Light's and Heffner's Criteria

Authors

  • Nordjannah Nordjannah Specialization Program of Medical Pathology, Faculty of Medicine, University of Hassanudin/Dr. Wahidin Sudirohusodo General Hospital, Makassar
  • Ani Kartini Department of Clinical Pathology, Faculty of Medicine, University of Hassanudin/Labuang Baji Hospital Makassar
  • Darmawaty ER Department of Clinical Pathology, Faculty of Medicine, University of Hassanudin/Islamic Faisal General Hospital, Makassar

DOI:

https://doi.org/10.24293/ijcpml.v26i1.2181

Keywords:

Heffner's criteria, Light's criteria, transudate, exudate, pleural effusion

Abstract

Pleural effusion is an abnormal accumulation of pleural fluid in the pleural cavity due to excessive transudation or exudation. Light's criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications which led to development of several alternative criteria, such as Heffner's criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner's criteria to determine the type of pleural effusion. This research was an observational study with a cross-sectional method using a pleural effusion of patients at the Clinical Pathology Laboratory Installation at the Wahidin Sudirohusodo Hospital in July 2018. Total protein, LDH, and cholesterol levels were measured in all samples that met the inclusion and exclusion criteria. There were 45 pleural effusion samples that consisted of 30 transudate and 15 exudate samples. Based on clinical diagnosis, the Light's criteria showed 3 misclassifications and Heffner's criteria obtained showed 2 misclassifications. Based on the data above, the statistical data showed that Light's criteria had a sensitivity of 96.7% and specificity of 86.7%. Heffner's criteria had a sensitivity of 100% and specificity of 86.7%. Heffner's criteria can be used an alternative method to determine the type of pleural effusion because it showed a better sensitivity and specificity than Light's criteria.

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References

Hardjoeno, Fitriani M. Tes dan interpretasi cairan pleura dalam substansi dan cairan tubuh. Ed Baru., Makassar, Lembaga Penerbitan Universitas Hasanuddin, 2011; 67–84.

Lilian AM, Kristy S. Graff's textbook of urinalysis and rd body fluids. 3 Ed., Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins, 2016; 203-6. 3

. Light RW, McGregor MI, Luchisinger PC, Ball WC. Pleural effusion: The diagnostic separation of transudates and exudates, An Intern Med, 1972; 507-513.

Chakko SC, Caldwell SH, Forza PPS. Treatment of congestive heart failure. Its effect on pleural fluid chemistry. Chest, 1989; 95: 798-802.

Porcel JM, Pena JM, Vicente C. Bayesian analysis using continous likelihood ratios for identifying pleural exudates. Respiratory Medicine, 2006 ; 1960-165

Heffner JE, Brown LK, Barbieri CA. Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Chest, 2002; 970-80.

Hamal AB, Yogi KN, Bam SK. Pleural fluid cholesterol in differentiating exudative and transudative pleural effusion. Pulmonary Medicine. 2013; 13: 1-5.

Patel AK, Choundury S. Combined pleural fluid cholesterol and total protein in differentiation of exudates and transudates. Indian J Chest Dis Allied Science, 2013; 21-3.

Guntur MJ, Alwinsyah A, Ermanta NK. Pemeriksaan protein, kolesterol dan laktat dehidrogenase cairan pleura sebagai parameter dalam membedakan efusi pleura transudat dan eksudat. Majalah Kedokteran Nusantara. 2017; 50(3): 146-49.

Alexander C, Marin K. Pleural disorder in the intensive care unit. Second Ed., Philadelphia, Lippincott Williams and Wilkins, 2012; 107-15.

Khairani R, Syahruddin E, Partakusuma LG. Karakteristik efusi pleura di Rumah Sakit Persahabatan. Jurnal Respirologi, 2012; 12(32): 155-160.

Dwianggita P. Etiologi efusi pleura pada pasien rawat inap di Rumah Sakit Umum Pusat Sanglah, Denpasar. Intisari Sains Medis, 2016; 7(1): 57-66.

Sahn SA. Diagnosis and management of parapneumonic effusions and empyema. Clinical Infectious Disease Journal. Charleston. 2007; 45(11): 1480-86.

Light RW. Disorders of the pleura and mediastinum. In: th Harrisons' pulmonary and critical care medicine. 17 Ed., San Fransisco, McGraw Hill Medical, 2010; 215-219.

Syahruddin E, Avisenna DP, Nirwan A. A retrospective study: Clinical and diagnostic characteristics in advanced stage of lung cancer patients with pleural effusion in Persahabatan Hospital. Journal Respirologi Indonesia, 2010; 146-51.

Dhandapani S, Reddy S, Rajagopalan R. Differentiating pleural effusions: Criteria based on pleural fluid cholesterol. Eurasian J Pulmonal, 2016; 18: 76-9.

Ekpe EE, Essien I, Idongesit U. Significant pleural effusion in congestive heart failure necessitating pleural drainage. Nigerian Journal of Cardiology, 2015; 12(2): 106-10.

Seth B, Belok S, Schembri F. An exudative pleural effusion in congestive heart failure: Time to broaden the differential, case reports. American Journal of Respiratory and Critical Care Medicine, 2018; 150-59.

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Submitted

2023-06-02

Published

2023-06-02

How to Cite

[1]
Nordjannah, N., Kartini , A. and ER, D. 2023. Evaluation of Pleural Effusion Type Determination Based on Light’s and Heffner’s Criteria . INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 26, 1 (Jun. 2023), 76–80. DOI:https://doi.org/10.24293/ijcpml.v26i1.2181.

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