THE ‘UNTAPPED’ POTENTIAL OF TUNNELED PLEURAL CATHETERS

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THE ‘UNTAPPED’ POTENTIAL OF TUNNELED PLEURAL CATHETERS TPC Presentation THE ‘UNTAPPED’ POTENTIAL OF TUNNELED PLEURAL CATHETERS (pun intended) Mrinalini Krishnan, M.D. Troy Moritz, D.O., FACOS PinnacleHealth Harrisburg Hospital Harrisburg, PA

Background / Methodology Purpose: assess the off-label use of Tunneled Pleural Catheters (TPCs) to ‘tap’ recurrent non-malignant pleural effusions secondary to chronic end-stage diseases Hypothesis: placement of TPCs will decrease in-patient re-admissions for exacerbations of pleural effusions Retrospective chart review of 98 patients – 37 patients included with recurrent, non-malignant pleural effusions Patients set up with homecare support, draining 2-3 times per week, and followed out-patient until catheter removal

Patient Characteristics Total Number of Patients 37 Age (Mean, SD, Range) 73.95 + 13.43 30 – 92 Gender (Female, n, %) 17 45.95% Co-morbid Conditions (n,%) Hypertension 32 86.49% Chronic Kidney Disease 22 59.46% Congestive Heart Failure 25 67.57% Liver Disease 4 10.81% Malnutrition 8 21.62% Multiple Conditions 33 89.19%

Re-admissions Before & Re-admissions Before & After TPC Removed (n=31) After TPC Placed (n=37) Re-admissions Before & After TPC Removed (n=31) The average re-admission rates for all measures with TPC intervention are significantly reduced, p<0.0001

Results / Conclusion Re-admissions significantly decreased in 3 months and 1 year before to after TPC was placed, as well as removed Both statistically significant, p<0.0001 In conclusion, placement of Tunneled Pleural Catheters decrease in-patient re-admissions in non-malignant pleural effusions, and placing these catheters can ‘tap’ this statistically significant application of TPCs