What is senstivity and specificity of Light’s criteria for distinguishing between exudative and transudative pleural effusions?

Bottom line:  Still considered gold standard for differentiating transudates and exudates, Light’s criteria has a 98% sensitivity and 83% specificity for exudates.

Summary:  DynaMed summary on Pleural Effusion, Diagnostic Evaluation summarizes evidence in the section Differentiating Exudate from Transudate.   Light’s criteria:  ratio of pleural fluid protein to serum protein > 0.5;  ratio of pleural fluid lactate dehydrogenase (LDH) to serum LDH > 0.6;  pleural fluid LDH level > 2/3 upper limit of normal for serum LDH.   DynaMed references:

Yataco JC, Dweik RA.  Cleve Clin J Med. 2005 Oct;72(10):854-6, 858, 862-4.  Pleural effusions: evaluation and management.
Review includes discussion of methods proposed to differentiate exudates and transudates.  Compares in Table 3 (p. 858) Light’s criteria with newer proposed methods for differentiating transudates and exudates, none of which has demonstrated greater sensitivity and specificity.  Cites the original prospective study (Ann Intern Med. 1972 Oct;77(4):507-13. Light RW)

jkn 2/16

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About Amy

Clinical Informationist at EUH Branch Library
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