title: Differentiation between Transudate and Exudate in Pericardial Effusion has almost no Diagnostic Value in Contemporary Medicine.
abstract: BACKGROUND
  The biochemical analysis of pericardial fluid for differentiating transudate from exudate is often ordered and interpreted according to the criteria extrapolated from pleural effusions. However, the validity of this discrimination when applied to pericardial effusion is under question.
  
  
  METHODS
  Patients who underwent pericardiocentesis between January 2004 and February 2014 were identified. Among them, 216 had essential medical records available and constituted the study population. The parameters specifically analyzed were the following: lactate dehydrogenase, total protein and glucose concentrations in both pericardial fluid and serum; pericardial fluid/serum ratios of lactate dehydrogenase and total protein content; and pH and specific gravity of pericardial fluid.
  
  
  RESULTS
  Eighty-one percent of pericardial effusions were classified as exudate according to Light's criteria. Both exudate and transudate fluid characteristics were possible for all etiological causes except for tuberculosis in which all were exudates. Although multiple cutoff points for all parameters were tested, significant overlap between different causes persisted (all having an area under the receiver operating characteristic curve of < 0.7). Thus, a reasonable accuracy to differentiate one cause from another could not be achieved.
  
  
  CONCLUSIONS
  Although often ordered, the biochemical analysis of pericardial fluid has almost no diagnostic value to distinguish among causes of pericardial effusion in contemporary medicine.
authors.forename: Sukru
authors.initials: S
authors.lastname: Akyuz
authors.forename: Emre
authors.initials: E
authors.lastname: Arugaslan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Zengin
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.forename: Ufuk Sadik
authors.initials: US
authors.lastname: Ceylan
authors.forename: Baris
authors.initials: B
authors.lastname: Yaylak
authors.forename: Tugba
authors.initials: T
authors.lastname: Kemaloglu-Oz
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.forename: Nese
authors.initials: N
authors.lastname: Cam
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005122:Exudates and Transudates / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D010490:Pericardial Effusion / Q000737:chemistry / Q000175:diagnosis* / Q000209:etiology; D020519:Pericardiocentesis; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey
chemical_list: D015415:Biomarkers