Chest
Clinical InvestigationsThoracocentesis: Clinical Value, Complications, Technical Problems, and Patient Experience
Section snippets
Data Collection
Information was collected by one author (T. R.C.) from consecutive patients undergoing thoracocentesis on medical services in one of three university affiliated hospitals served by the same housestaff who rotated among the three hospitals—The University of Colorado Health Sciences Center (UH), The Denver Veterans Hospital (VAH), and Denver General Hospital (DGH)—during the following periods: Sept-Oct 1981 (VAH), Jan-Feb 1982 (DGH), May-July 1982 (UH), Oct-Dec 1982 (UH), Jan-May 1983 (UH, VAH).
RESULTS
Eighty-six (86) patients underwent 129 thoracocenteses. There were 54 men and 32 women ranging in age from 22 to 96 years, with a mean age of 56.4 years. Thirty-five patients had two or more thoracocenteses. The ratio of number of patients to number of thoracocenteses from each hospital medical service was: University Hospital, 46/62; Veterans Hospital, 27/47; Denver General Hospital, 13/20. The reason for the first thoracocentesis performed on each patient was diagnostic only in 65 of 86 (76
DISCUSSION
Our results show that pleural fluid analysis can yield clinically useful information in greater than 90 percent of patients; however, the diagnostic usefulness of thoracocentesis is enhanced by understanding its limitations. A definitive etiologic diagnosis was made in 18 percent of our patients, a relatively low figure. Referral centers that might evaluate a population with a high incidence of malignancy have reported as high as 35 percent definitive diagnoses.6, 8 The major “diagnostic” value
ACKNOWLEDGMENTS
The authors wish to thank Drs. Richard Hamman and Gary Zerbe and the medical housestaff of the University of Colorado Health Science Center for their cooperation, Dr. John Heffner for helpful suggestions, and Leann Holst for secretarial assistance.
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Presented in part at the Scientific Sessions of the American Federation for Clinical Research, Western Section, Carmel, CA, February 11, 1983, and American Thoracic Society, Kansas City, Kansas, May 10, 1983.
Manuscript received August 7; revision accepted November 11.