Aetiology and Management Practices of Pleural Effusions among Hospitalized Adult Patients at a Referral Facility in Kenya: A 5-Year Retrospective Study

Abstract

Background: Pleural Effusion (PE) is a condition associated with significant mortality and morbidity, with varying aetiologies influenced  by geography, patient age, and time trends. The variations in aetiologies of PE according to time necessitate the need to investigate the  current trends of causation, and management of pleural effusion in Kenya.

Objective: This study described the common practices of care  of patients presenting with PE at Kenyatta National Hospital in Kenya.

Methodology: We utilized a retrospective crosssectional  design, involving 1234 patients admitted with PE at Kenyatta National Hospital (KNH) between January 2018 and December 2022. The  data collected included information on aetiology, presentation, management practices, length of stay, and mortality associated with PE.  SPSS version 25 was used for data analysis. Continuous data was described using means and standard deviation. Proportions were  utilized in describing the categorical variables. Logistic regression model was applied on significant variables to assess for independent  risk factors for mortality due to pleural effusion and results to be reported in odds ratios and the associated 95% confidence interval.  

Results: The predominant presenting symptoms was dyspnea (80.1%). Exudative effusions were the most common (65.8%), with  tuberculosis being the primary cause of infectious effusions. Among transudative effusions, heart failure (53.0%) was the most common cause. Intercostal chest drainage, with large bore tubes, was a common therapeutic intervention. The average length of hospital stay was  18.57 days, and the mortality rate was 12.4%.

Conclusion: Pleural effusions remain to be the most common with infectious  aetiology as the predominant cause. There still remains a huge gap in unreported data and adoption of electronic data entry may be a   solution to this challenge.