{
  "abstract": "Background Indwelling pleural catheters (IPCs) are established for recurrent malignant pleural effusions (MPEs), offering symptom control and outpatient management. Current British Thoracic Society (BTS) guidance emphasises patient-centred decision-making and advises that the LENT prognostic scoring system could be used for planning MPE management. This would include deciding if IPC insertion is appropriate.Methods We conducted a retrospective analysis of 25 IPC insertions from 2023–24. In addition to the data required for LENT calculation, mortality, complications and IPC removal were reviewed. The LENT score was calculable in 17 patients and grouped as Low (0–1), Moderate (2–4), or High (5–7). We assessed survival duration and 1-month mortality by risk group.Results LENT Score Distribution (n=17;):Low Risk (n=3): 33% deceased (died at 1 month)Moderate Risk (n=12): 66%deceased; Median survival 1.5 months (range 1–9); 50% 1-month mortalityHigh Risk (n=2): 100% deceased; 100% 1-month mortalityComplications:Immediate: 6 Patients (2 admitted; no IPC removals) complications were Pain, Pneumothorax, BleedingDelayed: 5 Patients (4 admitted) complications were empyema, pain, accidentally cut in A&E.IPC Removals: 36% (9/25)N=3 removed due to delayed complications (pain, accidental cut, empyema)N= 6 removed due to spontaneous non-drainagePrior to IPC, 68% (17/25) had ≥1 pleural procedure—most commonly a single therapeutic drain.Conclusion/Recommendations LENT score stratification closely correlates with post-IPC survival. Low-risk patients (18%) showed excellent outcomes, supporting IPC use in this group. Moderate-risk patients (70%) had highly variable trajectories. Despite a median survival of 1.5 months, some died within days, highlighting the importance of combining LENT scoring with clinical judgement. In high-risk patients (12%), rapid mortality questions IPC utility, suggesting one-off large-volume aspiration and symptom palliation (e.g., morphine) may be more appropriate.We acknowledge the small sample size. Importantly LENT scoring requires pleural aspiration prior to IPC consideration. If incorporated into decision making this would preclude up front IPC insertion even if malignancy is highly suspected. This increases the number of required patient attendances. Nonetheless, integrating the LENT score supports BTS aim of outcome-driven, individualised care.",
  "authors": [
    {
      "affiliations": [
        "London North West University Healthcare NHS Trust, London, UK"
      ],
      "name": "M Ilyas"
    },
    {
      "affiliations": [
        "London North West University Healthcare NHS Trust, London, UK"
      ],
      "name": "T Sathyamoorthy"
    },
    {
      "affiliations": [
        "London North West University Healthcare NHS Trust, London, UK"
      ],
      "name": "P Ramachandran"
    }
  ],
  "title": "P277 LENT score utilisation in indwelling pleural catheter (IPC) pathways: an audit-based recommendation",
  "uid": "269469f4-801e-5f30-a1c7-6b8e701cb401"
}