title: Benefit of serum-effusion albumin gradient in congestive heart failure patients.
abstract: 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.
  
  
  METHODS
  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 bypass 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Chest Department, Central Chest Institute of Thailand. piamlarp@yahoo.com
authors.forename: Piamlarp
authors.initials: P
authors.lastname: Sangsayunh
authors.forename: Boonjong
authors.initials: B
authors.lastname: Saejueng
mesh_terms: D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D010996:Pleural Effusion / Q000209:etiology / Q000378:metabolism; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000378:metabolism*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*
chemical_list: D004232:Diuretics; D012709:Serum Albumin