Open AccessIndications and clinical outcomes of indwelling pleural catheter placement in patients with malignant pleural effusion in a cancer setting hospital
Author(s) -
Akram Muhammad Junaid,
Khalid Usman,
Bakar Muhammad Abu,
Butt Faheem Mahmood,
Ashraf Mohammad Bilal,
Khan Faheem
Publication year - 2020
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.13239
Subject(s) - medicine , pleural effusion , malignant pleural effusion , lung cancer , surgery , logistic regression , proportional hazards model , neutropenia , lung infection , lung , chemotherapy
Background The placement of indwelling pleural catheters (IPC) is an effective outpatient approach for the management of malignant pleural effusions (MPE). Aims The indications and outcome of IPC in patients with MPE. Risk stratifications, prevention and management of IPC‐related complications.Methods We retrospectively reviewed the clinical data of patients with MPE who underwent IPC insertion from July 2011 to July 2019. The multivariable logistic regression model was used to identify the independent risk factors associated with IPC infection and the Kaplan–Meier method to determine the overall survival. Results A total of 102 patients underwent IPC insertion during the stipulated period and the mean age was 50.49 ± 14.36 years. Seventy‐one (69.6%) were females. The indications were Trap Lung in 38 (37.3%), failed talc pleurodesis in 28 (27.5%) and as a primary intervention in 36 (35.3%). The infection rate was 25.5%, of which 65.4% patients had nosocomial infections. Post‐IPC overall median survival time was 9.0 ± 2.50 weeks with highest in patients with trap lung (18 ± 1.50 weeks). In multivariable analysis, following variables were identified as a significant independent risk factor for IPC infection: Multiloculated MPE (AOR 2.80; 95%CI (1.00‐9.93), 0.04), trap lung (AOR 7.57; 95%CI (1.39‐41.25), 0.01), febrile neutropenia (FN) (AOR 28.55; 95%CI (4.23‐19.74), 0.001), IPC domiciliary education (AOR 0.18; 95%CI (0.05‐0.66), 0.001) and length of hospital stay (AOR 1.16; 95%CI (1.01‐1.33), 0.03). Conclusion IPC insertion is an effective management for MPE with reasonable survival benefits. Infection is the most common complication, of which mostly are nosocomial infections with higher incidence in multiloculated effusions, trap lung, FN and with lack of domiciliary IPC care education.