Inpatient mortality and its predictors after pericardiocentesis: An analysis from the Nationwide Inpatient Sample 2009–2013

Sethi, Ankur; Singbal, Y.; Kodumuri, Vamsi; Prasad, Vinoy

doi:10.1111/joic.12563

Cited by 8 publications

(10 citation statements)

References 30 publications

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“…Pericardiocentesis may be associated with minor and major complications that include but are not limited to: pneumothorax, catheterization of the wrong site and/or organ, cardiac puncture, coronary artery laceration, massive hemorrhage, and intra‐procedural death . Studies reporting the risk of complications with pericardiocentesis have variable findings with some studies showing complication rates as low as 1.2% while others reporting an increased risk of complications and mortality as high as 18% . The significance of understanding the utilization patterns of pericardiocentesis nationwide is important.…”

Section: Introductionmentioning

confidence: 99%

“…Pericardiocentesis associated with different cardiac procedures [Color figure can be viewed at wileyonlinelibrary.com] possible complication that is often treated with pericardiocentesis.However, due to the complex and comorbid condition of that patient subset and the concurrent medications used, the risk of cardiac tamponade is exceptionally high in cases with iatrogenic effusion due to the acute accumulation of blood and fluids in the pericardium further complicating patient status and worsening outcomes. One singlecenter study found high mortality among patients undergoing percutaneous aortic valve repair (TAVR) that was reported as approximately one in every four in cases that developed cardiac tamponade 9. Yet, another study reported lower mortality numbers in patients undergoing electrophysiologic procedures (EP) 18.…”

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confidence: 99%

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Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Gad

Elgendy

Mahmoud

et al. 2019

Cathet Cardio Intervent

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Background Data regarding the temporal trends, outcomes, and predictors of in‐hospital mortality after pericardiocentesis are limited. Methods The National Inpatient Sample database was used to extract hospitalizations of patients who underwent pericardiocentesis from January 2007 to September 2015. We examined the rates of in‐hospital mortality, its predictors, and the temporal trends of pericardiocentesis utilization in the United States during the study period. We also examined trends and outcomes of pericardiocentesis associated with different cardiovascular procedures. Results A total of 96,377 hospitalizations with pericardiocentesis were examined. The number of pericardiocentesis procedures performed trended up significantly between 2007 and 2015 (p trend <.001), and this increase was observed predominantly in patients with unstable conditions. In‐hospital mortality after pericardiocentesis decreased over time (14.6% in 2007 vs. 12.0% in 2015, p trend <.001), but remained higher than that after surgical pericardial intervention (13.1 vs. 8.9%, p value <.0001), predominantly attributable to a higher patient risk profile. Rates of in‐hospital mortality were not statistically different between the procedural cohort and the nonprocedural cohort, 13.5 versus 13.0%, p value = .051. After multivariable adjustment, structural heart interventions (odds ratio [OR] 2.86; 95% confidence interval [CI] 2.35–3.49), bacterial and/or infective endocarditis (OR 2.09; 95% CI 1.72–2.54) and active neoplasms (OR 1.72; 95% CI 1.6–1.85) were independently associated with increased in‐hospital mortality in pericardiocentesis patients. Conclusion In this nationwide analysis, the number of pericardiocentesis procedures increased significantly over time. Structural interventions, endocarditis, and active neoplasms were associated with increased in‐hospital mortality after pericardiocentesis.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Gad

Elgendy

Mahmoud

et al. 2019

Cathet Cardio Intervent

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“…Our region shows similar characteristics to the literature in terms of cancer prevalence detected in patients who underwent pericardiocentesis. In our study, cancer was diagnosed in 24 (26%) patients; this rate was reported between 25.3-31.5% in large-scale cohort studies 12,2,6 . In addition, lung cancer is the most common malignancy (54%) in our region, it has been reported between 44-52.9% in the literature 12,2,6 .…”

Section: Discussionmentioning

confidence: 45%

“…In addition, lung cancer is the most common malignancy (54%) in our region, it has been reported between 44-52.9% in the literature 12,2,6 . In parallel with other studies evaluating inpatient mortality, it was found higher in cancer patients in our study also 6,12 . Recently, pericardial effusion and tamponade due to tuberculosis have not been reported in developed countries, nor were they detected in the patient population we evaluated.…”

Section: Discussionmentioning

confidence: 76%

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Cancer prevalence, inpatient mortality and its predictors after pericardiocentesis

Çerik

Dindaş

Koyun

et al. 2020

Cumhuriyet Medical Journal

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Pericardiocentesis is a percutaneous drainage procedure performed in cardiac tamponade or a moderate-large pericardial effusion that does not respond to medical treatment. The prognosis varies according to the etiology of pericardial effusion, and the parameters that can determine the prognosis are unknown. In this study, we aimed to find predictors that can determine inpatient mortality in patients who underwent pericardiocentesis and to determine cancer etiology. Method: Ninety-one patients who underwent pericardiocentesis due to moderate-large pericardial effusion or pericardial tamponade were evaluated retrospectively. Baseline characteristics of the patients, their cancer diagnosis before and after pericardiocentesis, pericardial effusion cytology, echocardiographic parameters and laboratory parameters in the baseline evaluation were evaluated. The group with inpatient death (n = 14) and the surviving group (n = 77) were compared with each other. Results: There was no significant difference between baseline demographic characteristics and echocardiographic parameters when the patients with inpatient mortality and survivors were compared; only patients diagnosed with cancer (p <0.001) and patients with malignant cytology (p = 0.041) were statistically significantly higher in the group with inpatient mortality. When patients with inpatient mortality and survivors were compared in terms of laboratory parameters, aspartate aminotransferase (AST) [55 (27-455), 26 (19-45); p = 0.007, respectively], lactate dehydrogenase (LDH) [527 (438-944), 282 (225-381); p <0.001, respectively], C-reactive protein (CRP) [120.5 (19.8-140.7), 36.5 (8.26-86.15); p = 0.016, respectively], NTproBNP [8964 (7780-9432), 1310 (351-4556); p = 0.049] values were significantly higher in the inpatient mortality group than in the surviving group. The presence of cancer (p = 0.001), AST (p = 0.008), alanine aminotransferase (ALT) (p = 0.013), LDH (p = 0.015), CRP (p = 0.046) parameters were detected to be predictors that can be used to predict inpatient mortality in the univariate logistic regression analysis conducted to determine the predictors that could indicate inpatient mortality. Conclusions: Inpatient mortality is high in patients that were detected to have underlying malignancy and pericardial involvement after pericardiocentesis. In the initial evaluation of these patients, simple laboratory tests such as AST, ALT, NTproBNP, LDH, CRP can give an idea about the short-term prognosis of the disease.

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Percutaneous pericardiocentesis for pericardial effusion: predictors of mortality and outcomes

et al. 2021

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Pericardial effusion can dangerously precipitate patient’s hemodynamic stability and requires prompt intervention in case of tamponade. We investigated potential predictors of in-hospital mortality, a composite outcome of in-hospital mortality, pericardiocentesis-related complications, and the need for emergency cardiac surgery and all-cause mortality in patients undergoing percutaneous pericardiocentesis. This is an observational, retrospective, single-center study on patients undergoing percutaneous pericardiocentesis (2010–2019). We enrolled 81 consecutive patients. Median age was 71.4 years (interquartile range [IQR] 58.1–78.1 years) and 51 (63%) were male. Most of the pericardiocentesis were performed in an urgency setting (76.5%) for cardiac tamponade (77.8%). The most common etiology was idiopathic (33.3%) followed by neoplastic (22.2%). In-hospital mortality was 14.8% while mortality during follow-up (mean 17.1 months) was 44.4%. Only hemodynamic instability (i.e., cardiogenic shock, hypotension refractory to fluid challenge therapy and inotropes) was associated with in-hospital mortality at the univariate analysis (odds ratio [OR] 7.2; 95% confidence interval [CI] 1.76–29.4). Non-neoplastic/non-idiopathic etiology and hemodynamic instability were associated with the composite outcome of in-hospital mortality, need for emergency cardiac surgery, or pericardiocentesis-related complications (OR 5.75, 95% CI 1.65–20.01, and OR 5.81, 95% CI 2.11–15.97, respectively). Multivariate Cox regression analysis adjusted for possible confounding variables (age, coronary artery disease, and hemodynamic instability) showed that neoplastic etiology was independently associated with medium-term mortality (hazard ratio [HR] 4.05, 95% CI 1.45–11.36). In a real-world population treated with pericardiocentesis for pericardial effusion, in-hospital adverse outcomes and medium-term mortality are consistent, in particular for patients presenting with hemodynamic instability or neoplastic pericardial effusion.

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Inpatient mortality and its predictors after pericardiocentesis: An analysis from the Nationwide Inpatient Sample 2009–2013

Cited by 8 publications

References 30 publications

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Cancer prevalence, inpatient mortality and its predictors after pericardiocentesis

Percutaneous pericardiocentesis for pericardial effusion: predictors of mortality and outcomes

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