Relationship of pleural fluid pH and glucose: a multi-centre study of 2,971 cases

Deirdre B. Fitzgerald, Su Lyn Leong, Charley A. Budgeon, Kevin Murray, Andrew Rosenstengal, Nicola A. Smith, Silvia Bielsa, Amelia O. Clive, Nick A. Maskell, Jose M. Porcel, Y. C. Gary Lee

Research output: Contribution to journalArticle

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Abstract

Background: Pleural fluid pH and glucose levels are both recommended in the workup of pleural effusions. Whether their levels correlate and predict each other or contribute independent knowledge is unclear. We aimed to investigate the pH/glucose relationship, assess their concordance and ascertain whether performing both tests provides additional information to performing either test alone.

Methods: The pH and glucose measurements from 2,971 pleural fluid samples, from three centers in Spain, UK and Australia, were categorized into Cancer (n=1,045), Infection (n=544), Tuberculosis (n=249) and Others (n=1,133) groups. The relationship between pH and glucose values and their concordance at clinically relevant cutoffs (pH 7.2 and glucose 3.3 mmol/L) were assessed.

Results: The mean pH of the cohort was 7.38 (SD 0.22) and median glucose 5.99 (range, 0.00-29.36) mmol/L. A regression model of the relationship between glucose (log-transformed) and pH with a restricted cubic spline showed linear (P

Conclusions: Pleural fluid pH and glucose have a strong non-linear relationship but, in most situations, the level of one cannot accurately predict the other. Concordance rates were high and either test is sufficient in the majority of cases.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalJournal of Thoracic Disease
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 2019

Cite this

Fitzgerald, Deirdre B. ; Leong, Su Lyn ; Budgeon, Charley A. ; Murray, Kevin ; Rosenstengal, Andrew ; Smith, Nicola A. ; Bielsa, Silvia ; Clive, Amelia O. ; Maskell, Nick A. ; Porcel, Jose M. ; Lee, Y. C. Gary. / Relationship of pleural fluid pH and glucose : a multi-centre study of 2,971 cases. In: Journal of Thoracic Disease. 2019 ; Vol. 11, No. 1. pp. 123-130.
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abstract = "Background: Pleural fluid pH and glucose levels are both recommended in the workup of pleural effusions. Whether their levels correlate and predict each other or contribute independent knowledge is unclear. We aimed to investigate the pH/glucose relationship, assess their concordance and ascertain whether performing both tests provides additional information to performing either test alone.Methods: The pH and glucose measurements from 2,971 pleural fluid samples, from three centers in Spain, UK and Australia, were categorized into Cancer (n=1,045), Infection (n=544), Tuberculosis (n=249) and Others (n=1,133) groups. The relationship between pH and glucose values and their concordance at clinically relevant cutoffs (pH 7.2 and glucose 3.3 mmol/L) were assessed.Results: The mean pH of the cohort was 7.38 (SD 0.22) and median glucose 5.99 (range, 0.00-29.36) mmol/L. A regression model of the relationship between glucose (log-transformed) and pH with a restricted cubic spline showed linear (PConclusions: Pleural fluid pH and glucose have a strong non-linear relationship but, in most situations, the level of one cannot accurately predict the other. Concordance rates were high and either test is sufficient in the majority of cases.",
keywords = "Clinical decision making, empyema, glucose, hydrogen-ion concentration, pleural effusion, PATHOGENESIS, EFFUSIONS, SURVIVAL",
author = "Fitzgerald, {Deirdre B.} and Leong, {Su Lyn} and Budgeon, {Charley A.} and Kevin Murray and Andrew Rosenstengal and Smith, {Nicola A.} and Silvia Bielsa and Clive, {Amelia O.} and Maskell, {Nick A.} and Porcel, {Jose M.} and Lee, {Y. C. Gary}",
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Fitzgerald, DB, Leong, SL, Budgeon, CA, Murray, K, Rosenstengal, A, Smith, NA, Bielsa, S, Clive, AO, Maskell, NA, Porcel, JM & Lee, YCG 2019, 'Relationship of pleural fluid pH and glucose: a multi-centre study of 2,971 cases' Journal of Thoracic Disease, vol. 11, no. 1, pp. 123-130. https://doi.org/10.21037/jtd.2018.12.101

Relationship of pleural fluid pH and glucose : a multi-centre study of 2,971 cases. / Fitzgerald, Deirdre B.; Leong, Su Lyn; Budgeon, Charley A.; Murray, Kevin; Rosenstengal, Andrew; Smith, Nicola A.; Bielsa, Silvia; Clive, Amelia O.; Maskell, Nick A.; Porcel, Jose M.; Lee, Y. C. Gary.

In: Journal of Thoracic Disease, Vol. 11, No. 1, 01.2019, p. 123-130.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship of pleural fluid pH and glucose

T2 - a multi-centre study of 2,971 cases

AU - Fitzgerald, Deirdre B.

AU - Leong, Su Lyn

AU - Budgeon, Charley A.

AU - Murray, Kevin

AU - Rosenstengal, Andrew

AU - Smith, Nicola A.

AU - Bielsa, Silvia

AU - Clive, Amelia O.

AU - Maskell, Nick A.

AU - Porcel, Jose M.

AU - Lee, Y. C. Gary

PY - 2019/1

Y1 - 2019/1

N2 - Background: Pleural fluid pH and glucose levels are both recommended in the workup of pleural effusions. Whether their levels correlate and predict each other or contribute independent knowledge is unclear. We aimed to investigate the pH/glucose relationship, assess their concordance and ascertain whether performing both tests provides additional information to performing either test alone.Methods: The pH and glucose measurements from 2,971 pleural fluid samples, from three centers in Spain, UK and Australia, were categorized into Cancer (n=1,045), Infection (n=544), Tuberculosis (n=249) and Others (n=1,133) groups. The relationship between pH and glucose values and their concordance at clinically relevant cutoffs (pH 7.2 and glucose 3.3 mmol/L) were assessed.Results: The mean pH of the cohort was 7.38 (SD 0.22) and median glucose 5.99 (range, 0.00-29.36) mmol/L. A regression model of the relationship between glucose (log-transformed) and pH with a restricted cubic spline showed linear (PConclusions: Pleural fluid pH and glucose have a strong non-linear relationship but, in most situations, the level of one cannot accurately predict the other. Concordance rates were high and either test is sufficient in the majority of cases.

AB - Background: Pleural fluid pH and glucose levels are both recommended in the workup of pleural effusions. Whether their levels correlate and predict each other or contribute independent knowledge is unclear. We aimed to investigate the pH/glucose relationship, assess their concordance and ascertain whether performing both tests provides additional information to performing either test alone.Methods: The pH and glucose measurements from 2,971 pleural fluid samples, from three centers in Spain, UK and Australia, were categorized into Cancer (n=1,045), Infection (n=544), Tuberculosis (n=249) and Others (n=1,133) groups. The relationship between pH and glucose values and their concordance at clinically relevant cutoffs (pH 7.2 and glucose 3.3 mmol/L) were assessed.Results: The mean pH of the cohort was 7.38 (SD 0.22) and median glucose 5.99 (range, 0.00-29.36) mmol/L. A regression model of the relationship between glucose (log-transformed) and pH with a restricted cubic spline showed linear (PConclusions: Pleural fluid pH and glucose have a strong non-linear relationship but, in most situations, the level of one cannot accurately predict the other. Concordance rates were high and either test is sufficient in the majority of cases.

KW - Clinical decision making

KW - empyema

KW - glucose

KW - hydrogen-ion concentration

KW - pleural effusion

KW - PATHOGENESIS

KW - EFFUSIONS

KW - SURVIVAL

U2 - 10.21037/jtd.2018.12.101

DO - 10.21037/jtd.2018.12.101

M3 - Article

VL - 11

SP - 123

EP - 130

JO - Journal of Thoracic Disease

JF - Journal of Thoracic Disease

SN - 2072-1439

IS - 1

ER -