Introduction: The increase of pleural disease has seen rising demand for effective and efficient management of these conditions. Pleural day-case services offer one-stop assessments, imaging and intervention aiding early diagnosis, improved care and admission avoidance. 

Method: A retrospective analysis of patients presenting to the pleural service from September 2015 to December 2022 was performed. Patient characteristics, referral source, diagnosis, outcome and intervention were evaluated.

Results: 1699 patients were seen with 771 (45%) new cases, including 211 referrals from primary care (27.3%) and 72.7% from secondary care. Mean time to review from referral was 7.57 days for urgent suspected cancer (USC) and 16.42 days for non-USC. Amongst the new 771 cases, 592 (90.1%) were diagnostic and/or therapeutic aspirations with 65 (9.9%) related to tunneled indwelling pleural catheters (TIPC); Malignancy was identified in 42% of effusions.

Conclusion: Since establishing this service, significant positive financial and health outcomes have been achieved in the diagnosis and management of pleural disease. A total of at least 3084 hospital inpatient days were saved at a minimum cost of £1,233,600. This has led to a quick, efficient pleural disease management service reducing hospital bed pressures and providing respiratory specialist-led diagnosis, which also benefits the training of future specialists in this field.

References: 

1.Aujayeb A et al. A Review of a Pleural Service. J R Coll Physicians Edinb 2016; 46: 26-31
2.Hooper CE, Welham SA, Maskell NA. Pleural procedures and patient safety: a national BTS audit of practice. Thorax 2013;70(2):189-191.