A study of Light's criteria and possible modifications for distinguishing exudative from transudative pleural effusions.
OBJECTIVE
To determine the usefulness of modifying Light's criteria for the separation of pleural transudates from exudates.


METHODS
Retrospective review of patients who underwent a diagnostic thoracentesis during a 2-year period.


METHODS
Community teaching hospital in Lleida, Spain.


METHODS
Clinical records and pleural fluid characteristics of 230 consecutive patients with pleural effusion underwent a detailed review. Thirty-five of these patients were excluded from the analysis. As suggested recently by Romero et al, different cutoff levels for the criteria of Light et al were applied and their accuracies were calculated.


RESULTS
Thirty-nine (20%) pleural effusions were transudates and 156 (80%) were exudates. The accuracy of the criteria of Light et al for identifying exudates was 94.7% (confidence interval, 91.6 to 97.9) in comparison to our own modified criteria (93.1%; confidence interval, 89.5 to 96.7) and the criteria suggested by Romero et al (92.6%; confidence interval, 88.9 to 96.3). These differences were not statistically significant.


CONCLUSIONS
Changing the classic Light's criteria with different cutoff points offers no advantages for discriminating between transudative and exudative pleural effusions.
Vives
M
M
Department of Internal Medicine, University Hospital Arnau de Vilanova, Lleida, Spain.
Porcel
J M
JM
Vicente de Vera
M
M
Ribelles
E
E
Rubio
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005122:Exudates and Transudates / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000145:classification* / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity