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All Journal HAYATI Journal of Biosciences Indonesian Journal of Cancer Universa Medicina Jurnal Respirologi Indonesia Jurnal Ilmu Kefarmasian Indonesia Jurnal Respirasi (JR) Sumatera Medical Journal JURNAL PENELITIAN KEPERAWATAN MEDIK Respiratory Science Cermin Dunia Kedokteran Indonesian Journal of Cancer eJournal Kedokteran Indonesia
Elisna Syahruddin
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Universa Medicina

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Validity of pleural lactate dehydrogenase measurements in assessment of pleural effusions Elisna Syahruddin; Lia G. Partakusuma; Rita Khairani
Universa Medicina Vol. 31 No. 2 (2012)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2012.v31.105-112

Abstract

Background Pleural effusions are classified into transudates and exudates based on Light’s criteria, but the main disadvantage of Light’s criteria is the misclassification of transudates as exudates in about 20% of cases. The aim of this study was to determine the validity of various biochemical parameters to differentiate pleural exudates and transudates.MethodsAn observational study to evaluate diagnostics tests was conducted at the emergency department of Persahabatan Hospital, Jakarta, from September 2010 until December 2011. In total, 119 patients with pleural effusion were evaluated. Simultaneous pleural effusion and blood samples were examined for lactate dehydrogenase (LDH), total protein, cholesterol and albumin, with the clinical diagnosis as the gold standard. ResultsThere were 104 exudative and 15 transudative pleural effusions. Light’s criteria achieved a higher overall accuracy (sensitivity 97%, specificity 80%, accuracy 95%). The optimum cut off values were pleural fluid to serum ratio of LDH 0.4 (sensitivity 95%, specificity 87%, accuracy 94%) and pleural fluid LDH of 178 IU/L (sensitivity 92%, specificity 87%, accuracy 92%). Pleural fluid cholesterol was 50 mg/dL (sensitivity 89%, specificity 53%, accuracy 85%), pleural fluid to serum cholesterol ratio 0.41 (sensitivity 75%, specificity 53%, accuracy 72%) and serum-effusion albumin gradient 1.3 g/dL (sensitivity 91%, specificity 73%, accuracy 89%). Combination of biochemical tests did not improve sensitivity or accuracy.ConclusionsLight’s criteria remain superior to other biochemical tests, but the new cut off values of LDH pleural fluid to serum ratio of 0.4 and pleural fluid LDH of 178 IU/L appears to yield a slight improvement in diagnostic accuracy.
Co-Authors Abul A'la Al Maududi Afiani, Dina Ahmad Hudoyo Ahmad Hudoyo AHMAD HUDOYO Aldri Frinaldi Alma Thahir Pulungan Ana Rima Ana Rima Setijadi Ananda, Fannie Rizki Andalucia, Rizka Andarini, Sita Andi Yasmon Andreas Infianto Anna Rozaliyani Annisa Dian Harlivasari Anwar Jusuf Anwar Jusuf Arfiansyah, Mochammad Aris Aria Kekalih Arif Faisal ARIF R HANAFI ARIF R HANAFI, ARIF R Arif Santoso Arif Santoso Ath-Thobari, Jarir AZIZA G ICKSAN AZIZA G ICKSAN, AZIZA G Aziza Icksan Aziza Icksan Buana, Indra Budiman Bela Denny Grecius Siregar Dian Cahyadi Dian Yulianti Duyen, Natalie Erlina Burhan Ermayanti, Sabrina Ermayanti, Sabrina Erni Mudhiati EVLINA SUZANNA, EVLINA Fariz, Nurwidya Feni Fitriani Fera Ibrahim Ferry Dwi Kurniawan Findra Setianingrum Fitri Nurhayati GRACE SHALMONT, GRACE Hanif, Muhammad Alfin Haryati Haryati Haryati Haryati Hasbullah Thabrany Heriawaty Hidajat Heriawaty Hidajat, Heriawaty Hidayat, Moulid Ida Ayu Jasminarti Ida Ayu Jasminarti Dwi Kusumawardani Infianto, Andreas Jasminarti, Ida Ayu Kurniawan, Ferry Dwi Laksmi Wulandari Lia G. Partakusuma Lim, Darren Wan-Teck Lisnawati Lisnawati Melva Louisa Mia Elhidsi Mulatsari, Esti Mulyati Tugiran Nathaniel Aditya Noni Novisari Soeroso Novita Andayani, Novita Nurmadani, Labbaika PRADNYA SRI RAHAYU, PRADNYA SRI Pratama, Avissena Dutha Pratiwi, Suryanti Dwi Putra, Andika Chandra Putra, Muhammad Yusuf Adira Rahmat Hidayat Ramadhaniah, Fariha Rianyta Rianyta Ridhawati Sjam Rita Khairani Robiatul Adawiyah Romi Baginta Santoso, Andintia Aisyah Saputra, Tetra Arya Sarah Fitriani Sayekti, Mutia A. Setiaputra Setiaputra Setyawan, Ungky Agus Shanty R. Kusumawardani Sita Andarini Sita Andarini Sita Andarini Soehardiman, Dicky Solly Aryza Sri Melati Munir Sri Melati Munir Steven Jonathan Tamam Anugrah TAMSIL Tarigan, Setia Putra Taufik Ashar Vivian Soetikno Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Wira Winardi Yayi DB Susanto Yopi Simargi Yopi Simargi, Yopi Yuliyanti, Sayekti Yusi Anggriani Zahrah Annisa Zaini, Jamal