Preoperative laboratory parameters and comorbidities predict dignity in patients with pleural effusions

Background: Pleural involvement in lung diseases remains clinically inapparent in early stages, significantly impacting patient prognosis. Current procedures used to assess the etiology of pleural effusions are invasive and have limited diagnostic accuracy. The aim of the study is to identify a panel of preoperative laboratory parameters and comorbidities that can predict the dignity and prognosis of patients with pleural effusions. Methods: All patients admitted at the Asklepios Lung Clinic Gauting (2019-2024) for surgical (diagnostic/ therapeutic) management of pleural effusions were retrospectively evaluated. A broad panel of laboratory parameters and comorbidities (Charlson Comorbidity Index/ CCI) were recorded upon admission and analyzed in relation to effusion dignity by descriptive statistics, receiver operating characteristics and logistic regression analysis. Results: Overall, 649 patients (31.4% females, age 69.0[57.0, 78.0]years, BMI 24.0[22.0, 27.0]kg/m 2 ) with pleural effusions admitted at the Thoracic Surgery Department of the Asklepios Lung Clinic Gauting were included. In total, 726 operations were performed. 149 (23%) patients experienced malignant pleural effusion on histopathological specimens. Patients with benign effusions were younger (67.0[54.0, 77.0] vs 74.0[63.0, 81.0]years, p