CLINICO-ETIOLOGIGAL PROFILE OF PATIENTS ADMITTED WITH PLEURAL EFFUSION IN A TERTIARY CARE CENTRE

Résumé

Background: Pleural effusion is a collection of fluid abnormally present in the pleural space, usually resulting from excess fluid production and/or decreased lymphatic absorption.  It is the most common manifestation of pleural disease, and its etiologies range in spectrum from cardiopulmonary disorders and/or systemic inflammatory conditions to malignancy. Pleural effusion is a common diagnostic problem. Successful treatment of these cases depends upon establishing the exact etiology.

Objective: To determine the clinico-aetiological profile of patients with pleural effusion admitted in Department of General Medicine and allied specialities in a tertiary care hospital.

Study design: Prospective hospital based study.

Participants: 200 patients (130 Males and 70 Females mean age 53.8±19.18 years) were taken and proper history and relevant investigations were done to ascertain the etiology.

Materials and methods: It was a cross sectional study carried out at the Department of internal Medicine and allied specialities, from to September 2017 to June 2019. Inclusion criteria were all patients above 18 years of age with clinical and radiological evidence of pleural effusion. The study population was subjected to complete history taking, physical examination, baseline and other relevant investigations.

Results: The most common clinical presentation was Breathlessness in 77.5% of patients, followed by cough(54%), chest pain(43.5%), fever(39.5%), edema(22.5%). Males were more involved. The pleural effusion was common on right side in 52% of patients. 18.5% were transudative and 81.5% were exudative. The most common etiology was tuberculosis (33.5%) followed by parapneumonic (20%), malignancy (16%), heart failure (13.5%).

Conclusion: Pleural effusion is a common finding in hospitalized patients. Most common presentation is breathlessness.Most common etiology is tuberculosis in this part of world. Thoracentesis followed by pleural fluid analysis is the best method to diagnose the underlying etiology. Thoracoscopic pleural biopsy also has good role in undiagnosed pleural effusion.

Implication: Urgent and relevant investigations lead to early diagnosis and treatment of the underlying disease.