• Chest · Mar 2014

    Controversies in concordance diagnosis pre and post test in malignant pleural effusions.

    • Sagrario Mayoralas Alises, Patricia Lazo Meneses, Esteban Perez Rodriguez, Carolina Gotera, Jonathan Cámara Fernández, Deisy Barrios Barreto, Salvador Diaz Lobato, Eva Mañas Baena, Rosa Mirambeaux Villalona, Paola Arrieta Narvaez, Carolina Jurkojc Mohremberger, Patricia Castro Acosta, and Maria Galarza Jimenez.
    • Chest. 2014 Mar 1;145(3 Suppl):339A.

    Session TitleLung Cancer Posters ISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: In previous studies we have shown that the pretest and posttest diagnostic concordance in Pleural effusions (PE) is moderate (K: 0.55). In terms of sensitivity, the ascites hydrothorax have the greatest concordance (93%) and neoplasic showed very low. Knowing the reasons for this discrepancy in neoplasic pleural effusions may be useful in clinical practice. Objectives: 1. Analyze the overall concordance according to aetiology of the PE. 2. Evaluate the specific concordance in neoplasic pleural effusions and the reasons for the disagreement.MethodsFrom 1994 to October 2012, 5800 thoracentesis have been studied in the pleural unit, of them we analyzed 2558 consecutive thoracentesis included in the database. All cases were studied according to the protocol of the pleural unit and have Pre-test and post-test diagnostic. The pre-test diagnosis was based on clinical evaluation, radiological and laboratory test and was made by physician (Pleura expert pulmonologist and medical resident). The final diagnosis was closed according to study results of pleural effusion, biopsy, treatment response and outcome. The statistical analysis used was descriptive, retrospective and analyzed by the McNemar test.ResultsOf the 2558 cases analyzed 1621 were men (63.4%) and 937 women (36.6%) and the mean age was 65.39 + / - 16.57 years. We analyzed 2558 cases, 2541 had diagnostic pretest and posttest (Table 1.), of which 530 were neoplasic (20.9%). The PE whose diagnosis was malignant pretest, the final diagnosis more frequent was malignant and idiopathic (Table 2). The most frecuente pretest diagnoses of neoplasic posttest diagnosis were: malignant (carcinomas, lymphomas, mesothelioma) and paramalignant. (Table 3) According to the McNemar test diagnostic concordance of neoplasic pretest / posttest showed a correlation of 44.8%. (Table 4)CONCLUSIONS: 1. Diagnostic concordance pretest / posttest is high in ascites and cardiac PE, but not in the neoplasic PE. 2. When the diagnosis pre-test is malignant, the most frequent final diagnosis is malignant (55%) and idiopathic. If the pre-test diagnosis is no malignant, the suspected is correct in 92% of the cases. 3. When the diagnosis posttest is neoplasic the most frecuent suspected pretest diagnosis are paramalignant, parapneumonic and tuberculosis.Clinical ImplicationsThere is a low concordance in malignant pleural effusion, it is important to evaluate the specific concordance in neoplasic pleural effusions and the reasons for the disagreement.DisclosureThe following authors have nothing to disclose: Paola Arrieta Narvaez, Esteban Perez Rodriguez, Carolina Gotera, Rosa Mirambeaux Villalona, Carolina Jurkojc Mohremberger, Patricia Lazo Meneses, Salvador Diaz Lobato, Sagrario Mayoralas Alises, Eva Mañas Baena, Jonathan Cámara Fernández, Patricia Castro Acosta, Maria Galarza Jimenez, Deisy Barrios BarretoNo Product/Research Disclosure Information.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.