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