title: Mortality Following Catheter Drainage Versus Thoracentesis in Cirrhotic Patients with Pleural Effusion.
abstract: Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion.
  
  
  
  In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients.
  
  
  
  The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010. In all, 2556 cirrhotic patients with pleural effusion were selected for the study and divided into the two groups (n = 1278/group) after propensity score matching.
  
  
  
  The mean age was 61.0 ± 14.3 years, and 68.9% (1761/2556) were men. The overall 30-day mortality was 21.0% (538/2556) and was higher in patients treated with catheter drainage than those treated with thoracentesis (23.5 vs. 18.6%, respectively, P < 0.001 by log-rank test). After Cox proportional hazard regression analysis adjusted by patient sex, age, and comorbid disorders, the risk of 30-day mortality was significantly higher in cirrhotic patients who accepted catheter drainage compared to thoracentesis (hazard ratio 1.30, 95% confidence interval 1.10-1.54, P = 0.003). Old age, hepatic encephalopathy, bleeding esophageal varices, hepatocellular carcinoma, ascites, and pneumonia were associated with higher risks for 30-day mortality.
  
  
  
  In cirrhotic patients with pleural effusion requiring drainage, catheter drainage is associated with higher mortality compared to thoracentesis.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Hung
authors.affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan. cwtseng2@gmail.com.|School of Medicine, Tzu Chi University, Hualien, Taiwan. cwtseng2@gmail.com.
authors.forename: Chih-Wei
authors.identifier: 0000-0002-6951-4646
authors.initials: CW
authors.lastname: Tseng
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan.|Division of Infectious Disease, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan.
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Yu-Hsi
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Kuo-Chih
authors.initials: KC
authors.lastname: Tseng
authors.affiliation: Department of Mathematics, Tamkang University, Tamsui, Taiwan.
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Tsai
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000401:mortality*; D004322:Drainage / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010996:Pleural Effusion / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D000069258:Thoracentesis / Q000009:adverse effects / Q000401:mortality*
keywords: Catheter drainage; Liver cirrhosis; Pleural effusion; Thoracentesis