PLEURAL CHOLESTEROL IN DIFFERENTIATING TRANSUDATES AND EXUDATES - A PROSPECTIVE-STUDY OF 232 CASES

Two hundred and four patients with pleural effusion were studied to in vestigate the utility of Light's criteria and pleural fluid cholestero l level (pCHOL) in the identification of exudative pleural effusion (E PE) and transudative pleural effusion (TPE). There were 48 TPE, 56 tum or, 47 tuberculous, 30 metapneumonic and 23 miscellaneous patients. A value greater than or equal to 54 mg/dl for pCHOL and greater than or equal to 0.32 for the pleura/serum cholesterol ratio (p/sCHOL) showed sensitivity (S) and specificity (Sp) of 95.5% and 91.6% for pCHOL, and 97.4% and 91.6% for p/sCHOL, respectively. Combined pCHOL and/or p/sC HOL showed a S of 98.7% and Sp of 89.5%. Light's criteria achieved a S of 100% and Sp of 64.5%. Combined pCHOL and p/sCHOL revealed a simila r accuracy to Light's criteria in EPE diagnosis but was found to be mo re exact in TPE diagnosis.