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The LENT score calculator is a tool for evaluating prognosis in patients with malignant pleural effusion by assessing four clinical parameters: LDH levels in pleural fluid, Eastern Cooperative Oncology Group (ECOG) performance score, serum neutrophil-to-lymphocyte ratio, and tumor type. Each parameter contributes to an overall score that provides insight into median survival expectations.

For determining the score:

- **LDH in pleural fluid (U/L):**
  - Less than 1,500 receives a score of 0
  - 1,500 or greater receives a score of 1

- **ECOG performance score:**
  - An asymptomatic patient scores 0
  - A symptomatic but ambulatory patient scores 1
  - A symptomatic patient spending less than 50% of the day in bed scores 2
  - A patient in bed more than 50% of the day or who is bedbound scores 3

- **Serum neutrophil-to-lymphocyte ratio:**
  - Less than 9 receives a score of 0
  - 9 or greater receives a score of 1

- **Tumor type:**
  - Mesothelioma or hematologic malignancy scores 0
  - Breast or gynecologic cancer, or renal cell carcinoma scores 1
  - Lung or any other cancer scores 2

The total LENT score is the sum of these individual assessments, ranging from 0 to 7. Interpretation of the total score is as follows:

- A score of 0 to 1 places the patient in the low-risk group, with a median survival of 319 days.
- A score of 2 to 4 is interpreted as moderate risk, correlating to a median survival of 130 days.
- A score of 5 to 7 indicates a high-risk group, with a median survival of 44 days.

This scoring system offers a structured way to estimate survival based on the interplay of these clinical variables, aiding clinicians in categorizing patients by risk to inform management and treatment planning decisions.

The LENT score is a prognostic scoring system used for patients with malignant pleural effusion (MPE). The acronym LENT stands for four parameters: LDH (Lactate Dehydrogenase), ECOG performance status (Eastern Cooperative Oncology Group), Neutrophil-to-lymphocyte ratio (NLR), and Tumor type. 

This calculator is specifically applicable to patients diagnosed with malignant pleural effusion, a condition characterized by the abnormal accumulation of fluid in the pleural space due to malignancy. 

The clinical utility of the LENT score lies in its ability to predict survival in patients with MPE. It helps clinicians to stratify patients into different risk groups (low, moderate, and high) based on their LENT score, which can guide treatment decisions and discussions about prognosis with patients and their families.

There are no specific exclusion criteria for the use of the LENT score. However, it may not be as accurate in patients with rare types of cancer or in those with incomplete clinical data.

LENT score for malignant pleural effusion

The Clinical PROMISE score calculator assesses the risk of 3-month mortality for patients with malignant pleural effusion by considering various clinical factors. Each factor is assigned a score based on predefined criteria and contributes to a total score, which reflects the mortality risk.

The inputs for the calculation and their respective scoring are as follows:

- **Previous chemotherapy**: 
  - Yes = 4 
  - No = 0

- **Previous radiotherapy**: 
  - Yes = 2 
  - No = 0

- **Hemoglobin, g/dL**: 
  - >= 16 = 0 
  - 14-16 = 1 
  - 12-14 = 2 
  - 10-12 = 3 
  - < 10 = 4

- **Serum white blood cell count, 10^9 cells/L**: 
  - < 4 = 0 
  - 4-6.3 = 2 
  - 6.3-10 = 4 
  - 10-15.8 = 7 
  - >= 15.8 = 10

- **C-reactive protein, IU/L**: 
  - < 3 = 0 
  - 3-10 = 3 
  - 10-32 = 5 
  - 32-100 = 8 
  - >= 100 = 11

- **ECOG performance status**: 
  - 0-1 = 0 
  - 2-4 = 7

- **Cancer type**: 
  - Mesothelioma = 0 
  - All other types of cancer = 4 
  - Lung = 5

The total score is calculated by summing the scores from each input factor. This total is then interpreted to provide an estimated risk of 3-month mortality:

- A score of 20 or less indicates a risk of 3-month mortality of less than 25%.
- A score between 21 and 27 suggests a 25-50% risk.
- A score between 28 and 35 implies a 50-75% risk.
- A score of 36 or higher reflects a risk of 3-month mortality of 75% or more.

This systematic approach helps in determining the prognosis for patients, providing valuable insights based on current medical data.

The Clinical Prediction of Outcome in Malignant Pleural Effusion (PROMISE) score is a clinical calculator used in the management of patients with malignant pleural effusion (MPE). MPE is a condition often associated with advanced malignancies, where fluid accumulates in the pleural space surrounding the lungs. 

The PROMISE score is used to predict the 3-month mortality rate in patients with MPE. It incorporates five clinical parameters: performance status, pleural fluid pH, serum albumin, serum lactate dehydrogenase, and serum neutrophil-to-lymphocyte ratio. Each parameter is assigned a score, and the total score is used to stratify patients into low, intermediate, and high-risk groups.

The clinical utility of the PROMISE score lies in its ability to guide clinical decision-making and patient counseling. It can help clinicians decide on the most appropriate management strategy for MPE, such as pleurodesis, indwelling pleural catheter placement, or conservative management.

The PROMISE score is not applicable to patients with non-malignant pleural effusions or those with incomplete clinical or laboratory data. It should also be used with caution in patients with multiple comorbidities or those receiving concurrent treatments that may affect

Pleural effusion

Background

Overview

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