ISSN: 2642-1143
Authors: Sujith Halappa, Gayathri Devi HJ*, Majeed Pasha MD and Padmaja MS
Background: Light’s criteria have been the gold standard to differentiate exudative from transudative pleural effusions. It requires biochemical estimations from both pleural fluid and serum which may not be feasible in all patients due to economic constraints. Pleural fluid cholesterol and Lactate Dehydrogenase (LDH) have been reported to be extremely useful in distinguishing between transudative and exudative pleural effusion. Methods: This was a Prospective Observational study carried out at a tertiary care hospital. In this study with a sample size of 76, pleural fluid cholesterol and LDH were analysed in patients with pleural effusion. Etiological diagnosis was based on clinical history with radiological imaging, biochemical and cytological examination of pleural fluid. Results: The study included 76 patients with 69.7% (n=53) males and 30.3% (n=23) females. The mean age of patients was 48.97 + 17.03 years. Of 76 cases, 62 were exudates and 14 transudates. The sensitivity and specificity of pleural fluid cholesterol (>45mg/dl) for distinguishing exudates from transudates was 98.4% and 86%, while for LDH (>200 mg/dl), 93.5% and 78.6% respectively. Pleural Fluid cholesterol and LDH together (Costa’s Criteria) had a sensitivity of 95% and specificity of 93% for differentiating effusions in comparison to gold standard Light’s criteria which had sensitivity and specificity of 100% and 71.4% which was statistically significant. Conclusion: Pleural fluid cholesterol and LDH were extremely sensitive and specific as well as highly cost effective for differentiating exudative from transudative effusions.
Keywords: Cholesterol; Lactate dehydrogenase; Light’s criteria; Costa’s criteria
