Download - Mrinalini Krishnan, M.D. Troy Moritz, D.O., FACOS PinnacleHealth Harrisburg Hospital Harrisburg, PA
Mrinalini Krishnan, M.D.Troy Moritz, D.O., FACOS
PinnacleHealth Harrisburg HospitalHarrisburg, PA
THE ‘UNTAPPED’ POTENTIALOF TUNNELED
PLEURAL CATHETERS(pun intended)
Purpose: assess the off-label use of Tunneled Pleural Catheters (TPCs) to ‘tap’ recurrent non-malignant pleural effusions secondary to chronic end-stage diseases
Hypothesis: placement of TPCs will decrease in-patientre-admissions for exacerbations of pleural effusions
Retrospective chart review of 98 patients – 37 patients included with recurrent, non-malignant pleural effusions
Patients set up with homecare support, draining 2-3 times per week, and followed out-patient until catheter removal
Background / Methodology
Patient Characteristics Total Number of Patients 37
Age (Mean, SD, Range) 73.95 + 13.43 30 – 92
Gender (Female, n, %) 17 45.95% Co-morbid Conditions (n,%) Hypertension 32 86.49%
Chronic Kidney Disease 22 59.46%
Congestive Heart Failure 25 67.57%
Liver Disease 4 10.81%
Malnutrition 8 21.62%
Multiple Conditions 33 89.19%
Re-admissions Before &After TPC Placed (n=37)
The average re-admission rates for all measures with TPC intervention are significantly reduced, p<0.0001
Readmissions within one year
Readmissions within 3 months
0102030405060
59
42
156
Before TPC placedAfter TPC placed
Re-admissions Before & After TPC Removed (n=31)
Readmissions within one year
Readmissions within 3 months
0102030405060
60
33
9 2
Before TPC removedAfter TPC removed
Re-admissions significantly decreasedin 3 months and 1 year before to after TPC was placed, as well as removed
Both statistically significant, p<0.0001
In conclusion, placement of Tunneled Pleural Catheters decrease in-patientre-admissions in non-malignant pleural effusions, and placing these catheters can ‘tap’ this statistically significant application of TPCs
Results / Conclusion