A Study on Combining Various Criteria to Differentiate the Property of Pleural (Peritoneal) Effusion

Objective To estimate the significance of combining Light's criteria and serum-effusion albumin (ALB) gradient criteria to separate pleural (peritoneal) transudates from exudates.Methods 113 patients with definitely pleural (peritoneal) effusion were measured with total protein (TP) of effusion and serum, lactate dehydrogenase (LDH), ALB, cholinesterase (CHE), total bilirubin (TBIL) and total cholesterol (TCH) by Hitachi 7600 Automatic Analyzer, The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of each criteria were calculated.Results The sensitivity, specificity, accuracy, PPV and NPV of Light's criteria were 96.2%, 73.5%, 89.4%, 89.4% and 89.3% respectively. And those of serum-effusion albumin gradient criteria were 78.5%, 85.3%, 79.7%, 92.4% and 61.7% respectively. However, among 9 patients with pleural transudates which was misdiagnosed by Light's criteria, 6 patients could be diagnosed correctly by serum-effusion albumin gradient criteria.Conclusions Light's criteria is still a good method for the separation of transudates from exudates. It is recommended that if a patient, especially with diuretics, is thought to have a transudative effusion but is diagnosed as exudates by Light's criteria, a serum-effusion albumin gradient test may be needed.