Volume : VIII, Issue : XII, December - 2019

VALIDATION OF LIGHT'S CRITERIA IN PLEURAL EFFUSION

Udaya. S, Arjun Ramaswamy, Potdar. P. V.

Abstract :

Background: Pleural effusion is one of the manifestation of various diseases with cardiopulmonary symptoms . The sensitivity and specificity of Light‘s criteria for detection of exudates are usually reported to be around 98% and 80%, respectively. This means that although Light‘s criteria are relatively accurate, twenty percent of patients are misclassified as exudates. Therefore, additional testing is needed in those where a patient identified by lights criteria as exudative effusion is clinically more likely to be transudative. In such a scenario, analysis of albumin, bilirubin and cholesterol levels in pleural fluid and serum maybe useful in differentiating between an exudative and transudative pleural effusion. Aims and objectives: 1. To validate light’s criteria . 2. To analyze albumin, bilirubin and cholesterol levels in pleural fluid and serum to differentiate between exudate and transudate. Methodology: A prospective non–interventional observational study where data from all the cases all patients (age >14years) detected having pleural from NOV 2015 to Dec 2016. Sample size : 100 OBSERVATION: Exudates and transudates can be differentiated by significant difference in pleural fluid protein level , pleural LDH, pleural albumin, pleural cholesterol, protein ratio , LDH ratio, albumin gradient , bilirubin ratio , cholesterol ratio and protein gradient with P value <0.05. For differentiating exudates and transudates pleural fluid bilirubin values are not statistically significant with P valve >0.05. For exudative effusion, maximum sensitivity was achieved by bilirubin ratio and pleural protein level and LDH ratio. While maximum specificity was shown by pleural protein and protein ratio. In comparison with Light’s criteria pleural protein sensitivity and specificity is 96.7% and 100% . LDH ratio sensitivity and specificity is 96.7% and 88.9%. pleural cholesterol levels 93.4 and 88.9% respectively which suggest pleural cholesterol is more sensitive and specific. CONCLUSION: In our study, among albumin bilirubin and cholesterol, for exudates, sensitivity is maximum for bilirubin ratio (98.9%) followed by cholesterol ratio (93.4%) and albumin gradient (84.6%). While specificity is maximum for albumin gradient (88.9%) followed by cholesterol ratio (77.8%) and bilirubin ratio (44.4%). Apart from validating light’s criteria, from our study we may conclude that when a diagnostic dilemma exists as to whether the case belongs to exudate or the transudate group, evaluating albumin and cholesterol may be worthwhile

Keywords :

Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

VALIDATION OF LIGHT'S CRITERIA IN PLEURAL EFFUSION, Udaya.S, Arjun Ramaswamy, Potdar.P.V. INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-12 | December-2019

Number of Downloads : 457

References :