Ho Ming-Yun, Wang Jian-Liang, Lin Yu-Sheng, Mao Chun-Tai, Tsai Ming-Lung, Wen Ming-Shien, Wang Chun-Chieh, Hsieh I-Chang, Hung Kuo-Chun, Wang Chao-Yung, Wu Huang-Pin, Chen Tien-Hsing
Division of Cardiology, Chang-Gung Memorial Hospital, Linkou, Taiwan.
Cardiology. 2015;130(1):37-45. doi: 10.1159/000368796. Epub 2014 Dec 10.
Echocardiography-guided pericardiocentesis has been the leading procedure for diagnosis and therapy of pericardial effusion. We aimed to identify risk factors for recurrence, complications, and mortality in pericardial effusion patients treated with pericardiocentesis.
We identified and collected data from 8,101 patients receiving pericardiocentesis between 1997 and 2010 from the Taiwan National Health Insurance Research Database. A multivariate regression model was used to investigate risk factors for recurrence, complications, and death.
There were 8,565 admissions among 8,101 patients. The most common underlying condition was malignancy (41%), especially lung cancer (23%), tuberculosis (9.0%), and acute pericarditis (8.2%). Surgical drainage was required in 12.7% of cases. Recurrence was more likely in patients with malignancy (HR 2.20, p < 0.001), but complications were less likely (OR 0.52, p = 0.003). In-hospital death numbers and complication risks (OR 2.38, p < 0.001; OR 1.27, p = 0.01) were greater in the catheter-related cardiac procedure group than in the other groups.
Malignant neoplasms and catheter-based cardiac procedures have become major risk factors for adverse events in patients receiving pericardiocentesis in Taiwan. Malignancy leads to an increase in recurrence and in-hospital mortality but is associated with a lower rate of acute complications. Cardiac catheterization procedures and surgery increase both complications and in-hospital mortality.
超声心动图引导下的心包穿刺术一直是心包积液诊断和治疗的主要方法。我们旨在确定接受心包穿刺术治疗的心包积液患者复发、并发症和死亡的危险因素。
我们从台湾国民健康保险研究数据库中识别并收集了1997年至2010年间接受心包穿刺术的8101例患者的数据。采用多因素回归模型研究复发、并发症和死亡的危险因素。
8101例患者中有8565次入院。最常见的基础疾病是恶性肿瘤（41%），尤其是肺癌（23%）、结核病（9.0%）和急性心包炎（8.2%）。12.7%的病例需要手术引流。恶性肿瘤患者更容易复发（风险比2.20，p<0.001），但并发症的发生率较低（比值比0.52，p = 0.0）。导管相关心脏手术组的住院死亡人数和并发症风险（比值比2.38，p<0.001；比值比1.27，p = 0.01）高于其他组。
在台湾，恶性肿瘤和基于导管的心脏手术已成为接受心包穿刺术患者发生不良事件的主要危险因素。恶性肿瘤会导致复发率和住院死亡率增加，但急性并发症发生率较低。心脏导管插入术和手术会增加并发症和住院死亡率。
