Interventional Pulmonology

Tellez Garcia E.a· Ost D.b· Grosu H.B.b

Author affiliations

aInternal Medicine, Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Mexico
bDepartment of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

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Article / Publication Details

First-Page Preview

Received: September 21, 2022
Accepted: January 19, 2023
Published online: January 31, 2023

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: A well-recognized therapy to improve the symptoms of patients with malignant pleural effusion (MPE), indwelling pleural catheters (IPCs) can also achieve spontaneous pleurodesis. Chemical pleurodesis is associated with a significant pro-coagulation and fibrinolytic environment. Hence, anticoagulation could theoretically interfere with this process. Objective: The aim of this study was to evaluate if anticoagulation can interfere with successful spontaneous pleurodesis in patients treated with IPC. Methods: This was a cohort study of all patients with MPE treated with IPC. The primary objective was to determine if anticoagulant use after IPC placement decreased the rate of spontaneous pleurodesis. The secondary objective was to identify other factors associated with spontaneous pleurodesis. We used a Fine-Gray subdistribution hazard model and a direct acyclic graph to identify variables associated with time to spontaneous pleurodesis. Results: Of the included 410 patients, 210 patients (51.2%) achieved pleurodesis and had their IPC removed. We found no association between anticoagulation and likelihood of pleurodesis. Multivariate analyses revealed that prior chemotherapy, ECOG score of 2–4 were associated with unsuccessful pleurodesis, while chemotherapy or radiotherapy after IPC placement remained associated with increased likelihood of spontaneous pleurodesis. Conclusions: We failed to demonstrate an association between anticoagulation and pleurodesis. We found that better performance status and chemotherapy or radiotherapy after IPC placement can increase the rate of pleurodesis and catheter removal.

© 2023 S. Karger AG, Basel

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First-Page Preview

Received: September 21, 2022
Accepted: January 19, 2023
Published online: January 31, 2023

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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