ArticleBMJ open respiratory research2026
Clinical outcomes of non-traumatic chylothorax at a Singapore tertiary referral hospital.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectiveWhile the management of traumatic chylothorax has advanced over the past two decades, outcomes for non-traumatic chylothorax remain poor, with a paucity of data to guide management and prognostication.
methodsWe performed a retrospective analysis of patients diagnosed with chylothorax between January 2020 and December 2024. Clinical data including interventions and clinical outcomes were recorded.
resultsWe evaluated 40 patients with a median age of 61 (IQR: 50-72) years. Cancer was the most common cause (67.5%), of which 18 (45%) patients had solid-organ malignancies and 9 (22.5%) had haematological malignancies. Other aetiologies included drug-induced (10%) and liver cirrhosis (7.5%). Despite dietary measures implemented in 65.0% of patients, 52.5% of patients required ≥2 pleural interventions, with chest drain and indwelling pleural catheter insertions performed in 32 (80.0%) and 8 (20.0%) patients, respectively. Lymphatic imaging was infrequently (20.0%) performed, with chyle leak identified in only one patient. The 90-day and 1-year mortality was 37.5% and 55.0%, respectively, with the highest 1-year mortality rates seen with solid organ cancers (83.3%) and liver cirrhosis (66.7%). Eighteen (45.0%) patients had clinical resolution of chylothorax, and this was highest in patients with drug-induced chylothorax (100.0%) followed by patients with haematological malignancies (66.7%).
conclusionNon-traumatic chylothorax secondary to haematological malignancies and drugs have more favourable outcomes compared with solid organ cancers and liver cirrhosis. This highlights the need for a personalised and multidisciplinary approach to the management of chylothorax.
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