Survival after intrapleural catheter (IPC) insertion for malignant pleural effusion (MPE): a retrospective audit of prognostic scoring tools in patients with MPE treated with an IPC in a district general hospital

Abstract

The use of IPCs to manage malignant pleural effusion (MPE) is increasingly common. Prognosis in MPE is variable so scoring tools such as LENT and PROMISE may help select patients likely to benefit from IPC treatment. We wanted to determine which tool best predicted mortality in our first cohort of patients with MPE treated with an IPC. We applied LENT and PROMISE scores retrospectively in patients treated with an IPC for MPE between February 2017 and October 2019. 61 patients (32M, 29F) were treated with an IPC during the study period. The median (IQR) age was 72 (64-81). Median survival was 147 (39-251) days post insertion. 12 patients experienced complications, predominately infection related. LENT scores (LS) were available in 36 and PROMISE scores (PRS) in 42 patients. The median LS was 3 (2-4) and PRS 19 (14-26). ECOG performance status (PS) 3 or above and inpatients were both consistent predictors of mortality within 3 months. Patients with a PRS of In our cohort of patients, the PROMISE score was more readily available and predicted 90 and 180 day survival better than the LENT score.