Indwelling peritoneal and pleural catheters in the management of malignant and non-malignant ascites and pleural effusion: experiences from a Danish tertiary center.

Recurrent pleural effusions and ascites significantly impair quality of life, particularly in patients with advanced malignant and non-malignant disease. Traditional management often relies on repeated hospital-based procedures, which provide temporary symptom relief but place a considerable burden on patients and healthcare systems. This retrospective cohort study evaluates the safety, effectiveness, and clinical outcomes of indwelling pleural and peritoneal catheters (IPCs and IPeCs) in 63 patients treated at Lillebaelt Hospital Vejle between October 2019 and October 2024. A total of 30 patients received IPCs and 33 received IPeCs. Most had malignant effusions or ascites, but a notable proportion had non-malignant causes such as heart failure, liver cirrhosis, or renal disease. Following catheter placement, median survival was 45 days for IPC patients and 34 days for IPeC patients. Infection rates were low: 17% of IPC patients developed superficial skin infections, all treated successfully with oral antibiotics, and 6% of IPeC patients developed peritonitis, with one case potentially unrelated to the catheter. Importantly, 70% of IPC and 76% of IPeC patients had no hospital visits due to catheter-related complications, supporting the safety and outpatient feasibility of these devices. Additionally, a substantial proportion of patients-23% (IPC) and 30% (IPeC) - were able to remain in their own homes, potentially with support from home care services, rather than requiring institutionalization. These findings underline the benefit of early catheter placement in supporting patient autonomy and symptom control. Our results confirm that IPCs and IPeCs are safe and effective for managing both malignant and non-malignant effusions, with low complication rates and high patient benefit. Our findings support broader use of these catheters in palliative care. Earlier consideration of catheter placement may further improve outcomes and quality of life.