Author + information
- Chad Joseph Zack,
- Paul Hermany,
- James McClurken,
- T. Sloane Guy,
- Howard Cohen,
- Crystal Gadegbeku,
- Alfred Bove and
- Riyaz Bashir
At this time, the comparative in-hospital outcomes for pericardiocentesis and surgical pericardiotomy (pericardial window) in patients with chronic kidney disease (CKD) and pericardial effusion are unknown.
The Nationwide Inpatient Sample (NIS) was used to identify patients with CKD who underwent either pericardiocentesis or pericardiotomy in the US from January 2005 to December 2010. After matching the two groups using propensity scores and the Elixhauser comorbidity risk index, 1,179 matched patients were identified in each group.
The in-hospital mortality was significantly higher in the pericardiocentesis group compared to the pericardiotomy group (19.2% vs. 12.7%; p <0.001). Rates of procedure-related hemorrhage (2.5% vs. 0.7%; p=0.001), renal insufficiency (1.1% vs. 0.3%; p=0.048), cardiac complications (4.1% vs. 2.3%; p=0.018) and respiratory complications (1.7% vs. 0.2%; p<0.001) were significantly higher in the pericardiotomy group than in the pericardiocentesis group. LOS was significantly longer (15.8 vs. 10.4 days; p<0.001) and total hospital charges were significantly higher ($117,899 vs. $82,272; p<0.001) in the pericardiotomy group as compared to the pericardiocentesis group.
This observational study demonstrates that in patients with CKD and pericardial effusion, pericardiotomy is associated with significantly lower in-hospital mortality than pericardiocentesis. However, pericardiotomy was associated with significantly higher morbidity and resource utilization.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pericardial Diseases
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 1250-144
- 2013 American College of Cardiology Foundation