1. The Prevalence and Diagnostic Significance of Eosinophilic Pleural Effusions: A Meta-Analysis and Systematic Review.
- Author
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Oba, Yuji and Abu-Salah, Tareq
- Subjects
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CHEST paracentesis , *CHI-squared test , *CINAHL database , *COMMUNICABLE diseases , *CONFIDENCE intervals , *EOSINOPHILS , *EPIDEMIOLOGY , *MEDICAL databases , *INFORMATION storage & retrieval systems , *MEDLINE , *META-analysis , *PLEURAL effusions , *SCALES (Weighing instruments) , *STATISTICS , *SYSTEMATIC reviews , *LOGISTIC regression analysis , *DATA analysis , *RELATIVE medical risk , *DATA analysis software , *DESCRIPTIVE statistics , *DISEASE risk factors - Abstract
Background: Eosinophilic pleural effusion (EPE) is defined by an eosinophil count of ≥10% in the pleural fluid and often caused by air or blood in the pleural space. The diagnostic significance of EPEs is still a matter of debate. Objective: The objective of this study was to systematically review the medical literature to evaluate the diagnostic significance of EPEs. Methods: Electronic databases were searched from 1950 to April 2010 to perform a meta-analysis. Data were extracted using standardized forms, and pooled odds ratios with 95% confidence intervals were calculated. A logistic regression analysis was also performed to evaluate the association between the pleural eosinophil counts and the likelihood of underlying causes of EPEs. Results: We identified a total of 687 cases of EPE. The most common cause of EPEs was malignancy (26%) followed by idiopathic (25%) and parapneumonic (13%) effusions. The likelihood of malignancy or tuberculosis was somehow lower in EPEs than in non-EPEs, but the differences were not statistically significant. The prevalence of malignancy was significantly lower in the group of patients that required a pathologic confirmation (21 vs. 30%; p = 0.01). The likelihood of malignancy was inversely correlated with the pleural fluid eosinophil counts. The likelihood of idiopathic effusion was significantly higher in EPEs than in non-EPEs. Conclusions: Malignancy was the most common cause of EPEs. EPEs appeared to be a negative predictor of malignancy when a pleural fluid eosinophil count was extremely high. EPEs were more likely to be idiopathic as compared with non-EPEs. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2012
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