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Mishra, Eleanor K. 
ORCID: https://orcid.org/0000-0002-5903-3005, Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Laskawiec-Szkonter, Magda, Maskell, Nicholas A. and Rahman, Najib M.
(2023)
Trial Protocol:Reaccumulation rate of pleural effusions after therapeutic aspiration: An observational cohort study to determine baseline factors associated with rate of pleural fluid reaccumulation following therapeutic aspiration in patients with malignant pleural effusion attending a pleural clinic (REPEAT).
NIHR Open Research, 3.
ISSN 2633-4402
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Abstract
Background: Malignant pleural effusion (MPE) is the build-up of pleural fluid in the space between the lung and chest wall due to advanced cancer. It is treated initially by large volume drainage (therapeutic aspiration). If the fluid reaccumulates, a definitive procedure is performed. There is wide variation in rate of reaccumulation. Patients with rapid reaccumulation often attend hospital as an emergency. Conversely, patients with slow reaccumulation do not need a definitive procedure and may experience cancelled or unnecessary procedures. This study aims to create and validate a multivariable prediction model to predict how quickly pleural fluid will reaccumulate in patients with MPE following therapeutic aspiration. Research question: Can we predict how quickly pleural fluid will reaccumulate in patients with MPEs? Methods: A total of 200 patients with known or suspected MPE attending for therapeutic aspiration will be recruited from 5–10 UK hospitals over 20 months. Patients will be enrolled prior to undergoing aspiration. Following this, they will undergo chest X-ray, which will be repeated one week later (treatment as usual). Rate of reaccumulation will be calculated based on change of size of the effusion seen on X-ray. Data will be collected on common clinical biomarkers e.g., size of effusion on pre-aspiration chest X-ray, volume of fluid drained. This data will be analysed to create a clinical score. A further validation cohort of 40 patients will be enrolled in parallel with creation of the score. Anticipated impact: The ability to predict rate of reaccumulation of MPE will enable patients and clinicians to make better informed treatment decisions. For patients with predicted rapid reaccumulation, a definitive procedure could be offered as first-line treatment, rather than a therapeutic aspiration. This will prevent emergency hospital admissions and decrease number of procedures. By contrast, patients whose effusions will recur slowly may avoid an unnecessary procedure.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: This study is funded by a National Institute for Health Research - Research for Patient Benefit grant. Funding Information: This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR201466). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: Copyright: © 2023 Mishra EK et al. |
| Uncontrolled Keywords: | breathlessness,cancer,pleural effusion,therapeutic aspiration,medicine (miscellaneous),epidemiology,health policy,public health, environmental and occupational health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2701 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 14 Dec 2024 01:40 |
| Last Modified: | 16 Dec 2024 01:43 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97995 |
| DOI: | 10.3310/nihropenres.13282.1 |
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