Factors Influencing the Survival of Patients with Pleural Effusion Without Clear Etiology

Bellinda Magdalena¹, Gurmeet Singh², Lisnawati³, Dicky L. Tahapary⁴

¹Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

²Div of Respirology and Critical Care, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

³Departmen of Anatomic Pathology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

⁴Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

*Corresponding author: Bellinda Magdalena

Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

E-mail: bellindamagdalena@gmail.com

Abstract

BACKGROUND: Undiagnosed pleural effusion is a common cause of respiratory distress worldwide and contribute to morbidity and mortality. OBJECTIVE: The aim of this study is to evaluate factors affecting mortality and determine the 30 day and 90 day survival of patients with pleural effusion undergoing medical thoracoscopy. METHODS: This prospective study was conducted on patients with pleural effusion of unknown etiology who were over 18 years old and underwent medical thoracoscopy in Dr. Cipto Mangunkusumo National General Hospital, a tertiary care hospital in Jakarta, Indonesia. The study included 57 patients with pleural effusion who underwent medical thoracoscopy from January 2023 to May 2024. Patients were monitored up to 90 days after medical thoracoscopy. Kaplan-Meier and Cox proportional hazard analysis was used to analyze the data. RESULTS: The 90-day survival rate was 74.63% (CI 66.36-82.88). Analysis using the cox proportional hazard showed male gender [HR 2.108 (CI 0.732-6.076), p=0.167)] and poor ECOG PS [HR 3.822 (CI 0.863-16.928), p=0.077] were factors directly influencing the 90-day mortality of patients with pleural effusion of unknown etiology undergoing medical thoracoscopy. CONCLUSION: The 90-day survival rate of patients with pleural effusion with unknown etiology undergoing medical thoracoscopy is 74.63% (CI 66.36-82.88). Patients with pleural effusion of unknown etiology undergoing medical thoracoscopy who were male and with worse ECOG PS were associated with a higher risk of mortality within 90 days post procedure. 

Keywords:  Pleural effusion, medical thoracoscopy, survival, mortality