Benefit of Serum-Effusion Albumin Gradient in Congestive Heart Failure Patients
Piamlarp Sangsayunh MD*, Boonjong Saejueng MD**
Affiliation : * Chest Department, Nonthaburi, Thailand ** Cardiovascular Department, Central Chest Institute of Thailand, Nothaburi, Thailand Thematic Poster in European respiratory society meeting 2011, Amsterdam
Objective : To compare between light’s criteria and serum-effusion (S-E) albumin gradient in diagnosis of transudate effusion
in congestive heart failure (CHF) patients.
Material and Method: Eighty-six patients who had pleural effusion and suspected CHF were enrolled in the present study
between October 2008- September 2010. Suspected CHF was defined by clinical or echocardiography. Inform consents were
given by all volunteers. Exclusion criteria was previous thoracotomy or coronary by pass graft 3 months before present study.
Thoracocentesis was done to evaluate transudate effusion by light’s criteria and S-E albumin gradient > 1.2 mg/dl.
Results : 12 (13.95%), 56 (65.11%),17 (19.76%) of all were pure pleural disease, pure CHF, combination of pleural disease
and CHF. Sensitivity/specificity/accuracy of S-E albumin gradients and light’s criteria in diagnosis of CHF (both pure and
combined) were 90.1/33.3/80.2% , 64.7/80.0/67.4%. No correlation between amount of diuretic drug and “exudate” criteria
from lights’ (p = 0.66). 25 (27.2%) patients were previous post thoracotomy or coronary bypass graft. 7 of 25 patients had
loculated effusion. There was correlation between previous surgery with loculated effusion and effusion from combination of
pleural disease and CHF (p = 0.22).
Conclusion : There is benefit to use S-E albumin gradient > 1.2 mg/dl to diagnosis patients who were suspected CHF with or
without pleural disease. The authors recommended to use S-E albumin gradients combined with Light’s criteria in suspected
CHF patients.
Keywords : Congestive heart failure, Serum-effusion albumin gradient, Lights’ criteria
