ArticleLife (Basel, Switzerland)2026
The Effectiveness of Pleural Cholesterol Levels in Differentiating Transudate from Exudate and Comparison with Light's Criteria.
Article in Life (Basel, Switzerland), 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
backgroundDifferentiating exudative from transudative pleural effusions is essential for accurate diagnosis and management. Although Light's criteria remain the standard diagnostic method, they may incorrectly classify a substantial proportion of transudative effusions as exudates. This study aimed to evaluate the diagnostic performance of pleural fluid cholesterol and compare it with Light's criteria.
methodsThis retrospective study included 751 patients with pleural effusion who underwent diagnostic evaluation between 2015 and 2024 and had a definitive etiological diagnosis. All patients underwent ultrasound-guided thoracentesis with simultaneous pleural fluid and serum biochemical analyses. Based on final etiological diagnosis, effusions were classified as transudative or exudative.
resultsThe mean age was 68.6 ± 15.8 years. Of the pleural effusions, 516 (68.7%) were exudative and 235 (31.3%) were transudative. Malignant pleural effusion was the most common cause of exudates, whereas congestive heart failure predominated among transudates. Pleural fluid cholesterol levels were significantly higher in exudative than transudative effusions (91.1 ± 30.7 vs. 28.9 ± 13.5 mg/dL,
conclusionsPleural fluid cholesterol measurement demonstrated high diagnostic accuracy in differentiating exudative and transudative pleural effusions and substantially reduced false exudate classification compared with Light's criteria. Routine assessment of pleural cholesterol may improve the diagnostic evaluation of pleural effusions.
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