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https://doi.org/10.15836/ccar2024.135

Intrahospital mortality of patients presenting with cardiac tamponade: retrospective analysis

Domagoj Vučić orcid id orcid.org/0000-0003-3169-3658 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Sergej Nadalin orcid id orcid.org/0000-0002-1601-9094 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Zvonimir Bosnić orcid id orcid.org/0000-0002-4101-9782 ; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
Ana Kovačević orcid id orcid.org/0000-0002-8909-9216 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Katica Cvitkušić Lukenda orcid id orcid.org/0000-0001-6188-0708 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia


Puni tekst: engleski pdf 287 Kb

str. 135-136

preuzimanja: 142

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Sažetak

Ključne riječi

cardiac tamponade; cisplatin; intrahospital mortality; pericardiocentesis

Hrčak ID:

314402

URI

https://hrcak.srce.hr/314402

Datum izdavanja:

8.2.2024.

Posjeta: 411 *



Introduction: The pericardium is a double-walled sac (consisting of visceral and fibrous layers) between which lies the pericardial space, enveloping the heart and the roots of blood vessels entering or exiting the heart (1). Although pericardial effusion can arise from various pathological conditions, its etiology is typically presumed based on clinical presentation and comorbidities, and an accurate diagnosis is established through biochemical, microbiological, and cytological analysis of the effusion. However, pericardiocentesis is an invasive procedure indicated when effusion onset is symptomatic or accompanied by tamponade, or when its etiology is unclear (2,3).

Patients and Methods: The retrospective analysis included 48 patients with echocardiographically confirmed cardiac tamponade of various etiologies in the period from 2016 to 2021. Descriptive statistical data are presented as a percentage. Due to a small sample size and uneven distribution, the examination of intrahospital mortality between patient groups, based on etiology and effusion treatment, was performed using the Fisher’s exact test and statistical significance was indicated as p-value < 0,05. The statistical analysis was conducted using IBM SPSS Statistics.

Results: The median age was 66.5 years (IQR 59-72 years), with a minimum value of 21 years and a maximum of 87 years (Table 1). No statistically significant difference in intrahospital mortality was found among patients with different etiologies of cardiac tamponade (p > 0.05). However, patients treated with a combination of cisplatin and pericardiocentesis had a lower mortality rate compared to those treated with pericardiocentesis alone, p < 0.05 (Figure 1).

TABLE 1 The patient characteristics.
No. of patients (%)
Sex
Males32 (66.7)
Females16 (33.3)
Etiology
Malignant disease19 (39.6)
Inflammation8 (16.7)
Post-procedural7 (14.6)
Other14 (29.2)
Therapy
No therapy1 (2.1)
Drainage36 (75.0)
Surgery8 (16.7)
Conservative3 (6.3)
Application of cisplatin
No39 (81.3)
Yes9 (18.8)
Intrahospital mortality
No35 (72.9)
Yes13 (27.1)
Total48 (100)
FIGURE 1 Statistically significant difference in intrahospital survival among patients treated with a combination of cisplatin and pericardiocentesis and those undergoing pericardiocentesis alone (p = 0.016 - Fisher’s exact test).
CC202419_3-4_135-6-f1

Conclusion: Malignant diseases are one of the leading causes of death worldwide, and when combined with pericardial effusion and tamponade, the most common ones are lung and breast cancer, melanoma, and lymphoma. The therapy of choice for acutely occurring pericardial effusion is pericardiocentesis, which alleviates symptoms and provides additional diagnostic possibilities. The effectiveness of cisplatin administration in combination with pericardiocentesis is independent of hemodynamic instability parameters and inflammatory markers in patients with recurrent pericardial effusion.

LITERATURE

1 

Little WC, Freeman GL. Pericardial disease. Circulation. 2006 March 28;113(12):1622–32. https://doi.org/10.1161/CIRCULATIONAHA.105.561514 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/16567581

2 

Sagristà-Sauleda J, Mercé AS, Soler-Soler J. Diagnosis and management of pericardial effusion. World J Cardiol. 2011 May 26;3(5):135–43. https://doi.org/10.4330/wjc.v3.i5.135 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/21666814

3 

Darocha S, Wilk M, Walaszkowska-Czyż A, Kępski J, Mańczak R, Kurzyna M, et al. Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis. In Vivo. 2018 March-April;32(2):373–9. https://doi.org/10.21873/invivo.11248 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/29475923


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