Mortality after treatment of malignant pleural effusions with indwelling pleural catheters versus chemical pleurodesis: a population-based study

Little is known about patient outcomes following treatment of malignant pleural effusions (MPE) in the real-world setting. We aimed to compare post-procedure all-cause mortality between individuals who received indwelling pleural catheter (IPC) insertion versus chemical pleurodesis for managing MPEs...

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Published in:Respiratory research 2024-11, Vol.25 (1), p.409-11, Article 409
Main Authors: Kwok, Chanel, Thavorn, Kednapa, Amjadi, Kayvan, Aaron, Shawn D, Kendzerska, Tetyana
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Care and treatment
Catheters
Catheters, Indwelling - adverse effects
Comparative analysis
Diagnosis
Female
Humans
Male
Middle Aged
Ontario - epidemiology
Palliative Medicine
Patient outcomes
Pleural Effusion, Malignant - mortality
Pleural Effusion, Malignant - therapy
Pleural effusions
Pleural Neoplasms
Pleurodesis
Pleurodesis - methods
Population Surveillance - methods
Retrospective Studies
Survival
Treatment Outcome
Citations: Items that this one cites
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Summary:Little is known about patient outcomes following treatment of malignant pleural effusions (MPE) in the real-world setting. We aimed to compare post-procedure all-cause mortality between individuals who received indwelling pleural catheter (IPC) insertion versus chemical pleurodesis for managing MPEs. We performed a retrospective population-based study using provincial health administrative data (Ontario, Canada) of adults with a MPE who underwent IPC insertion or chemical pleurodesis between 2015 and 2019. Individuals were followed until death or March 31, 2021. Difference in post-procedure mortality was calculated using inverse probability of treatment weighting (IPTW)-adjusted Cox proportional hazard regression analysis to balance potential confounders at baseline. We identified 4,790 (77.3%) individuals who received an IPC and 1,407 (22.7%) who had chemical pleurodesis for MPE. IPC insertions are increasing and chemical pleurodesis procedures are decreasing. The majority of IPCs were inserted in outpatients (61%), by pulmonologists (64.2%) and at sites with higher annual IPC volume, while chemical pleurodesis procedures were generally done by thoracic surgeons (74%) and at sites with higher annual pleurodesis volumes. In unadjusted comparison median time from initial cancer diagnosis to intervention was significantly longer in the IPC group (244 days, interquartile range [IQR]:33-903) compared to pleurodesis group (81 days, IQR:10-737; p 
ISSN:1465-993X
1465-9921
1465-993X
DOI:10.1186/s12931-024-03023-6