Pleural effusions as markers of mortality and disease severity: a state-of-the-art review.

ABSTRACT

PURPOSE OF REVIEW Pleural effusions are common and are the result of various etiologies. Malignant pleural effusion (MPE) has a known high mortality, but there is also increasing evidence that patients with benign pleural effusions also have a poor prognosis. This review will discuss the most recent literature on mortality and prognostication in patients with pleural effusion. RECENT FINDINGS: Survival in patients with MPE is influenced by many factors, the most significant of which are underlying tumor type, performance score, and markers of systemic inflammation. Prognostic models have been developed for patients with both MPE and those with pleural infection to aid with treatment decision-making and patient counseling. Patients with benign pleural effusions may benefit from more definitive treatment of their pleural effusion as opposed to repeated thoracentesis. SUMMARY: Both benign and MPEs are associated with high mortality. Prognostic models and studies comparing treatment modality effect on survival will continue to guide management of these complex problems.