Department of Respiratory Medicine, Norfolk & Norwich University Hospital, Norwich, UK.
Department of Respiratory Medicine, James Paget University Hospital, Lowestoft, UK.
Clin Respir J. 2024 Oct;18(10):e13795. doi: 10.1111/crj.13795.
This multi-centre retrospective cohort study aimed to determine whether the cause of an undiagnosed pleural effusion differed depending on if a patient presented as an outpatient or inpatient.
A total of 1080 adult patients (556 inpatients and 524 outpatients) presenting primarily with an undiagnosed pleural effusion from 1 January 2021 to 31 December 2022 from four UK hospitals were included.
We found malignant effusions were more common in outpatients compared to inpatients (48.3% vs. 36.0% p < 0.0001). Infection was common in inpatients but uncommon in outpatients (36.2% vs. 5.0% p < 0.0001). Other causes in all patients included heart and/or renal failure (13.1%) and non-specific pleuritis (5.6%). No diagnosis was possible in 11.8% of patients referred.
Investigative pathways should vary depending on whether patients present as an inpatient or outpatient.
本多中心回顾性队列研究旨在确定以胸腔积液为主要表现的患者，无论其以门诊还是住院形式就诊，其胸腔积液的病因是否存在差异。
本研究共纳入了自 2021 年 1 月 1 日至 2022 年 12 月 31 日期间，来自英国四家医院的 1080 名以胸腔积液为主要表现的成年患者（556 名门诊患者和 524 名住院患者）。
我们发现，与住院患者相比，门诊患者的恶性胸腔积液更为常见（48.3%比 36.0%，p<0.0001）。感染在住院患者中较为常见，但在门诊患者中较为少见（36.2%比 5.0%，p<0.0001）。所有患者中，其他病因还包括心肾衰竭（13.1%）和非特异性胸膜炎（5.6%）。有 11.8%的转诊患者无法明确诊断。
针对以胸腔积液为主要表现的患者，其诊疗路径应根据其以门诊还是住院形式就诊而有所不同。
