Chest
Original ResearchPulmonary ProceduresIndwelling Pleural Catheters Reduce Inpatient Days Over Pleurodesis for Malignant Pleural Effusion
Section snippets
Materials and Methods
This study forms part of the analyses of the Western Australian study of Malignant Pleural Effusion, approved by the Human Research Ethics Committees of the Sir Charles Gairdner, Fremantle, and Royal Perth Hospitals in Western Australia, and the University of Western Australia (approval number 2009-104). All patients provided written, informed consent.
Patients with MPE from the three major public teaching hospitals in Perth, Western Australia (population about 1.7 million) were recruited over
Baseline Demographics
Of the 160 patients with MPE enrolled, 65 had symptomatic and, in most cases, recurrent effusions that required definitive treatment. Thirty-four patients elected to be treated with an IPC and 31 with talc pleurodesis. The two groups were similar in their baseline characteristics (Table 1).
IPCs were inserted by the respiratory (n = 30), radiology (n = 3), and cardiothoracic (n = 1) services. As expected, more patients in the IPC group had incomplete lung re-expansion after initial drainage,
Discussion
This study confirmed in a prospective, pragmatic, patient-choice setting that the use of IPC significantly reduced the number of hospital bed days for patients with an MPE that required definitive treatment. The nonrandomized, patient-centered design whereby patients and clinicians were allowed to tailor therapy to individual circumstances replicated real-life settings. A median reduction of 11.5 hospital bed days is significant for these patients with limited life spans and can represent
Acknowledgments
Author contributions: Dr Lee is guarantor of the study.
Dr Fysh: contributed to study conception and design, data collection and patient care, manuscript drafting and revision, and final approval of the manuscript.
Dr Waterer: contributed to study conception and design, manuscript drafting and revision, and final approval of the manuscript.
Dr Kendall: contributed to study conception and design, manuscript drafting and revision, and final approval of the manuscript.
Dr Bremner: contributed to data
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Funding/Support: This project was funded by a grant from the State Health Research Advisory Council of the Western Australian Health Department and from the Sir Charles Gairdner Research Foundation. Dr Fysh receives scholarships from the National Health and Medical Research Council and the Lung Institute of Western Australia.
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