Article Text
Abstract
Introduction There is a lack of data evaluating the clinical effect on symptoms of pleural intervention procedures. This has led to the development of patient-reported outcome measures (PROMs) to define what constitutes patient benefit. The primary aim of this paper was to prospectively assess the effect of pleural procedures on PROMs and investigate the relationship between symptom change and clinical factors.
Methods We prospectively collected data as part of routine clinical care from 158 patients with pleural effusion requiring interventions. Specific questionnaires included two patient-reported scores (a seven-point Likert scale and a 100 mm visual analogue scale (VAS) to assess symptoms).
Results Excluding diagnostic aspiration, the majority of patients (108/126, 85.7%) experienced symptomatic benefit from fluid drainage (mean VAS improvement 42.6 mm, SD 24.7, 95% CI 37.9 to 47.3). There was a correlation between symptomatic benefit and volume of fluid removed post aspiration. A negative association was identified between the number of septations seen on ultrasound and improvement in dyspnoea VAS score in patients treated with intercostal chest drain.
Conclusion The results of our study highlight the effect of pleural interventions from a patient’s perspective. The outcomes defined have the potential to form the basis of a clinical useful tool to appraise the effect, compare the efficiency and identify the importance of pleural interventions to the patients.
- Pleural Disease
- mesothelioma
- empyema
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Footnotes
Contributors IP and NMR conceived the article, collected and analysed the data and wrote the manuscript; had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. EKM and NA designed the questionnaire for PROMs, critically revised and approved the final manuscript. AY, AT, RJH and JPC provided data on cases, critically revised and approved the final manuscript.
Funding Psallidas I is the recipient of a REPSIRE2 European Respiratory Society Fellowship RESPIRE2 – 2015 – 7160. Rahman NM is funded by the National Institute Health Research (NIHR) Oxford Biomedical Research Centre. Hallifax RJ is funded by a Clinical Training Fellowship from the Medical Research Council (MR/L017091/1). The founding sources have no role in writing the manuscript or the decision to submit it for publication. Psallidas I and Rahman NM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Disclaimer The founding sources have no role in writing the manuscript or the decision to submit it for publication.
Competing interests IP is the recipient of a REPSIRE2 European Respiratory Society Fellowship RESPIRE2-2015-7160. NMR is funded by the National Institute Health Research (NIHR) Oxford Biomedical Research Centre. RJH is funded by a Clinical Training Fellowship from the Medical Research Council (MR/L017091/1).
Patient consent The study has been discussed with the ethical committee in University of Oxford and is considered an audit of practice. Patient consent forms have not been obtained.
Ethics approval The study has been discussed with the ethical committee in University of Oxford and is considered an audit of practice.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Requests for access to data should be addressed to the corresponding author.