Via this retrospective analysis, researchers investigated biomarkers of survival in patients suffering from malignant pleural effusion (MPE). Participants included patients who had been pathologically diagnosed with MPE, irrespective of the type of primary malignancy, at Beijing Chao-Yang Hospital over 158 months. Based on Cox and logistic regression analyses, a new predictive model was constructed. Carcinoembryonic antigen level, monocyte count, N-terminal pro B-type natriuretic peptide level, and pleural effusion chloride level on admission, were the four routinely identified variables that behaved as predictors, in the alternative prognostic model (n = 281) (the CONCH prognostic score). On the basis of risk stratification, patients were categorized into three prognosis subgroups, with median survival spans of 17, 11, and 5 months, respectively. A significantly poorer survival was experienced by patients in the medium- and high-risk groups vs the low-risk group. Herein, the CONCH scoring system was constructed using four routinely detected variables, and not only the accuracy of this scoring system as a prognostic score was corroborated for patients with MPE, but also this system can offer guidance for the selection of interventions and management for MPE.