Skouras et al evaluated nonpurulent parapneumonic effusions using laboratory tests. These can help to separate complicated from noncomplicated effusions. The authors are from 401 General Military Hospital, Tzaneio General Hospital, University Hospital of Thessaly, Sismanoglion General Hospital and University of Athens in Greece.
Patient selection: nonpurulent parapneumonic effusion (associated with bacterial pneumonia, lung abscess or infected bronchiectasis)
Outcome: complicated effusion (effusion that requires pleural fluid drainage due to pleural inflammation and fibrosis)
Test
Cutoff
LR(+)
LR(-)
pH pleural fluid
< 7.248
17.93
0.11
LDH pleural fluid
> 828 IU/L
7.86
0.19
Glucose pleural
< 660 mg/L
6.17
0.08
CRP pleural fluid
> 78.5 mg/L
2.4
0.25
CRP serum
> 83 mg/L
3.11
0.62
cumulative likelihood ratio for a complicated effusion =
= PRODUCT(likelihood ratio for all 5 tests)
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