Outcomes of Patients with Indwelling Pleural Catheters (IPCs) complicated by Septated Pleural Effusions

<bold>Abstract Body</bold> Little is known about the outcomes of patients with IPC-related septations. We sought to evaluate the outcomes of patients who develop worsening septated pleural effusions after IPC insertion, from a cohort of patients with IPCs inserted between Jan 2019 to Dec 2022. A total of 239 patients were included and divided into two groups for analysis. Group 1 were patients who had septated or non-septated effusions and did not develop new septations/worsening septations after IPC insertion. Group 2 were patients who developed new or worsening septations after IPC insertion. Septations were found to have developed at a median of 98 days (IQR: 57-125) after IPC insertion. Intrapleural fibrinolytics were administered in 41.2% of patients in group 2. Patients in group 2 had a higher rate of pleural infection but significantly increased survival (Table 1). Comparing systemic oncological treatment, 45.2% of patients in group 1 did not receive treatment for their underlying disease, compared to 21.6% in group 2. <bold>Conclusion</bold> Patients who develop septations after IPC insertion have longer survival, but this may be confounded by differential use of systemic therapy. Further prospective studies are required to understand this potentially important association. <table-wrap><object-id>erj;64/suppl_68/PA3351/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>Group 1 (n=188)</td><td>Group 2 (n=51)</td><td>p-value</td></tr><tr><td>Malignant cause (%)</td><td>169 (89.9)</td><td>44 (86.3)</td><td>0.43</td></tr><tr><td>Pleural infection (%)</td><td>6 (3.2)</td><td>10 (19.6)</td><td><0.001</td></tr><tr><td>Total duration of IPC in situ, days (IQR)</td><td>70 (34-120)</td><td>111 (63-169)</td><td><0.001</td></tr><tr><td>Received intrapleural fibrinolytics</td><td>1 (0.5)</td><td>21 (41.2)</td><td><0.001</td></tr><tr><td>Died with IPC in situ</td><td>122 (64.9)</td><td>18 (35.3)</td><td><0.001</td></tr><tr><td>Median survival after IPC insertion, days (IQR)</td><td>74 (35-261)</td><td>243 (92-396)</td><td><0.001</td></tr></tbody></table></table-wrap> Table 1. Patient outcomes.