Routine measurement of pleural fluid amylase is not indicated

Paul Branca, R. Michael Rodriguez, Jeffrey T. Rogers, Dereje S. Ayo, J. Phillip Moyers, Richard W. Light

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: The routine measurement of pleural fluid amylase is frequently recommended, but the cost-effectiveness of this procedure is unknown. Methods: To assess the utility of routine measurement of pleural fluid amylase in evaluating pleural effusions, we measured amylase, glucose, lactate dehydrogenase, and protein levels and blood cell counts in 379 patients undergoing thoracentesis during a 22-month period from 1997 to 1999. Of these, 199 had effusions after cardiac surgery; 61, malignant; 48, transudative; 28, parapneumonic; 2, chylous; 2, rheumatoid; 1, tuberculous; and 1, from chronic pleuritis. There were 37 exudates of unknown origin. Results: Measurement of pleural fluid amylase levels did not assist in determining the origin of the effusion in any of the patients. Amylase levels greater than 100 U/L (normal serum level in our laboratory is 30-110 U/L) were found in 5 (1.3%) of 379 patients: 1 patient with congestive heart failure (amylase, 173 U/L), 2 with post-cardiac surgery effusions (144 U/L and 130 U/L), 1 with pneumonia (109 U/L), and 1 with lung cancer (105 U/L). Conclusions: The routine measurement of pleural fluid amylase levels is neither clinically indicated nor cost-effective. We suggest that pleural fluid serum amylase levels be measured only if there is a pretest suspicion of acute pancreatitis, chronic pancreatic disease, or esophageal rupture.

Original languageEnglish (US)
Pages (from-to)228-232
Number of pages5
JournalArchives of Internal Medicine
Volume161
Issue number2
DOIs
StatePublished - Jan 22 2001
Externally publishedYes

Fingerprint

Amylases
Thoracic Surgery
Glucose 1-Dehydrogenase
Pancreatic Diseases
Pleurisy
Blood Cell Count
Exudates and Transudates
Pleural Effusion
Serum
L-Lactate Dehydrogenase
Pancreatitis
Cost-Benefit Analysis
Rupture
Lung Neoplasms
Pneumonia
Chronic Disease
Heart Failure
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Branca, P., Rodriguez, R. M., Rogers, J. T., Ayo, D. S., Moyers, J. P., & Light, R. W. (2001). Routine measurement of pleural fluid amylase is not indicated. Archives of Internal Medicine, 161(2), 228-232. https://doi.org/10.1001/archinte.161.2.228

Routine measurement of pleural fluid amylase is not indicated. / Branca, Paul; Rodriguez, R. Michael; Rogers, Jeffrey T.; Ayo, Dereje S.; Moyers, J. Phillip; Light, Richard W.

In: Archives of Internal Medicine, Vol. 161, No. 2, 22.01.2001, p. 228-232.

Research output: Contribution to journalArticle

Branca, P, Rodriguez, RM, Rogers, JT, Ayo, DS, Moyers, JP & Light, RW 2001, 'Routine measurement of pleural fluid amylase is not indicated', Archives of Internal Medicine, vol. 161, no. 2, pp. 228-232. https://doi.org/10.1001/archinte.161.2.228
Branca, Paul ; Rodriguez, R. Michael ; Rogers, Jeffrey T. ; Ayo, Dereje S. ; Moyers, J. Phillip ; Light, Richard W. / Routine measurement of pleural fluid amylase is not indicated. In: Archives of Internal Medicine. 2001 ; Vol. 161, No. 2. pp. 228-232.
@article{6bfb93ce64e141bc8965f39e598421ad,
title = "Routine measurement of pleural fluid amylase is not indicated",
abstract = "Background: The routine measurement of pleural fluid amylase is frequently recommended, but the cost-effectiveness of this procedure is unknown. Methods: To assess the utility of routine measurement of pleural fluid amylase in evaluating pleural effusions, we measured amylase, glucose, lactate dehydrogenase, and protein levels and blood cell counts in 379 patients undergoing thoracentesis during a 22-month period from 1997 to 1999. Of these, 199 had effusions after cardiac surgery; 61, malignant; 48, transudative; 28, parapneumonic; 2, chylous; 2, rheumatoid; 1, tuberculous; and 1, from chronic pleuritis. There were 37 exudates of unknown origin. Results: Measurement of pleural fluid amylase levels did not assist in determining the origin of the effusion in any of the patients. Amylase levels greater than 100 U/L (normal serum level in our laboratory is 30-110 U/L) were found in 5 (1.3{\%}) of 379 patients: 1 patient with congestive heart failure (amylase, 173 U/L), 2 with post-cardiac surgery effusions (144 U/L and 130 U/L), 1 with pneumonia (109 U/L), and 1 with lung cancer (105 U/L). Conclusions: The routine measurement of pleural fluid amylase levels is neither clinically indicated nor cost-effective. We suggest that pleural fluid serum amylase levels be measured only if there is a pretest suspicion of acute pancreatitis, chronic pancreatic disease, or esophageal rupture.",
author = "Paul Branca and Rodriguez, {R. Michael} and Rogers, {Jeffrey T.} and Ayo, {Dereje S.} and Moyers, {J. Phillip} and Light, {Richard W.}",
year = "2001",
month = "1",
day = "22",
doi = "10.1001/archinte.161.2.228",
language = "English (US)",
volume = "161",
pages = "228--232",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Routine measurement of pleural fluid amylase is not indicated

AU - Branca, Paul

AU - Rodriguez, R. Michael

AU - Rogers, Jeffrey T.

AU - Ayo, Dereje S.

AU - Moyers, J. Phillip

AU - Light, Richard W.

PY - 2001/1/22

Y1 - 2001/1/22

N2 - Background: The routine measurement of pleural fluid amylase is frequently recommended, but the cost-effectiveness of this procedure is unknown. Methods: To assess the utility of routine measurement of pleural fluid amylase in evaluating pleural effusions, we measured amylase, glucose, lactate dehydrogenase, and protein levels and blood cell counts in 379 patients undergoing thoracentesis during a 22-month period from 1997 to 1999. Of these, 199 had effusions after cardiac surgery; 61, malignant; 48, transudative; 28, parapneumonic; 2, chylous; 2, rheumatoid; 1, tuberculous; and 1, from chronic pleuritis. There were 37 exudates of unknown origin. Results: Measurement of pleural fluid amylase levels did not assist in determining the origin of the effusion in any of the patients. Amylase levels greater than 100 U/L (normal serum level in our laboratory is 30-110 U/L) were found in 5 (1.3%) of 379 patients: 1 patient with congestive heart failure (amylase, 173 U/L), 2 with post-cardiac surgery effusions (144 U/L and 130 U/L), 1 with pneumonia (109 U/L), and 1 with lung cancer (105 U/L). Conclusions: The routine measurement of pleural fluid amylase levels is neither clinically indicated nor cost-effective. We suggest that pleural fluid serum amylase levels be measured only if there is a pretest suspicion of acute pancreatitis, chronic pancreatic disease, or esophageal rupture.

AB - Background: The routine measurement of pleural fluid amylase is frequently recommended, but the cost-effectiveness of this procedure is unknown. Methods: To assess the utility of routine measurement of pleural fluid amylase in evaluating pleural effusions, we measured amylase, glucose, lactate dehydrogenase, and protein levels and blood cell counts in 379 patients undergoing thoracentesis during a 22-month period from 1997 to 1999. Of these, 199 had effusions after cardiac surgery; 61, malignant; 48, transudative; 28, parapneumonic; 2, chylous; 2, rheumatoid; 1, tuberculous; and 1, from chronic pleuritis. There were 37 exudates of unknown origin. Results: Measurement of pleural fluid amylase levels did not assist in determining the origin of the effusion in any of the patients. Amylase levels greater than 100 U/L (normal serum level in our laboratory is 30-110 U/L) were found in 5 (1.3%) of 379 patients: 1 patient with congestive heart failure (amylase, 173 U/L), 2 with post-cardiac surgery effusions (144 U/L and 130 U/L), 1 with pneumonia (109 U/L), and 1 with lung cancer (105 U/L). Conclusions: The routine measurement of pleural fluid amylase levels is neither clinically indicated nor cost-effective. We suggest that pleural fluid serum amylase levels be measured only if there is a pretest suspicion of acute pancreatitis, chronic pancreatic disease, or esophageal rupture.

UR - http://www.scopus.com/inward/record.url?scp=0035931283&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035931283&partnerID=8YFLogxK

U2 - 10.1001/archinte.161.2.228

DO - 10.1001/archinte.161.2.228

M3 - Article

VL - 161

SP - 228

EP - 232

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 2

ER -