Mrinalini Krishnan, M.D.

Troy Moritz, D.O., FACOS PinnacleHealth Harrisburg Hospital Harrisburg, PA

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Purpose: assess the off-label use of Tunneled Pleural Catheters (TPCs) to ‘tap’ recurrent non-malignant pleural effusions secondary to chronic end-stage diseases

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Hypothesis: re-admissions placement of TPCs will decrease in-patient for exacerbations of pleural effusions

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Retrospective chart review of 98 patients – included 37 patients with recurrent, non-malignant pleural effusions

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Patients set up with homecare support, draining 2-3 times per week, and followed out-patient until catheter removal

Total Number of Patients Age (Mean, SD, Range) Gender (Female, n, %) Co-morbid Conditions (n,%) Hypertension Chronic Kidney Disease Congestive Heart Failure Liver Disease Malnutrition Multiple Conditions 37 73.95 + 13.43

17 32 22 25 4 8 33 30 – 92 45.95% 86.49% 59.46% 67.57% 10.81% 21.62% 89.19%

60 40 20 0

Re-admissions Before & After TPC Placed (n=37)

59 42 15 6 Readmissions within one Readmissions within 3 year months Before TPC placed After TPC placed

Re-admissions Before & After TPC Removed (n=31)

60 60 40 20 0 9 33 2 Readmissions within one Readmissions within 3 year months Before TPC removed After TPC removed The average re-admission rates for all measures with TPC intervention are significantly reduced, p<0.0001

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Re-admissions significantly decreased in 3 months and 1 year before to after TPC was placed, as well as removed

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Both statistically significant, p<0.0001

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In conclusion, placement of Tunneled Pleural Catheters decrease in-patient re-admissions pleural effusions, in non-malignant and placing these catheters can ‘tap’ this statistically significant application of TPCs