Shih Chun-Ting, Lee Wei-Chieh, Fang Hsiu-Yu, Wu Po-Jui, Fang Yen-Nan, Chong Shaur-Zheng
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
J Cardiovasc Dev Dis. 2021 Nov 6;8(11):150. doi: 10.3390/jcdd8110150.
(1) Background: This study aimed to evaluate the etiologies and clinical outcomes of patients with pericardial effusion (PE) treated with echo-guided percutaneous pericardiocentesis. (2) Methods: Between July 2010 and December 2020, a total of 502 patients underwent echo-guided percutaneous pericardiocentesis for PE at our hospital. The reasons for PE were malignancy (N = 277), and non-malignancy (N = 225). The comorbidities, complications, and all-cause mortality were compared between the malignancy and non-malignancy groups. (3) Results: In multivariable Cox regression analyses for 1-year mortality, malignancy related PE, nasopharyngeal and oropharyngeal cancer, and metastatic status were positive predictors. A higher incidence of in-hospital and 1-year mortality were observed in patients with malignancy-related PE than with non-malignancy-related PE. In patients with malignancy-related PE, the Kaplan-Meier curve of 1-year all-cause mortality significantly differed between patients with or without metastasis; however, PE with or without malignant cells did not influence the prognosis. (4) Conclusions: In the patients with large PE requiring percutaneous pericardiocentesis, malignancy-related PE, nasopharyngeal and oropharyngeal cancer, and metastatic status were positive predictors of 1-year mortality. In patients with malignancy, a higher incidence of all-cause mortality was noted in patients with metastasis but did not differ between the groups with and without malignant cells in PE.
(1) 背景:本研究旨在评估经超声引导下经皮心包穿刺术治疗的心包积液(PE)患者的病因及临床结局。(2) 方法:2010年7月至2020年12月期间,我院共有502例患者因心包积液接受了超声引导下经皮心包穿刺术。心包积液的病因包括恶性肿瘤(N = 277)和非恶性肿瘤(N = 225)。比较了恶性肿瘤组和非恶性肿瘤组的合并症、并发症及全因死亡率。(3) 结果:在多变量Cox回归分析1年死亡率时,恶性肿瘤相关心包积液、鼻咽癌和口咽癌以及转移状态是阳性预测因素。观察到恶性肿瘤相关心包积液患者的院内及1年死亡率高于非恶性肿瘤相关心包积液患者。在恶性肿瘤相关心包积液患者中,有转移和无转移患者的1年全因死亡率的Kaplan-Meier曲线有显著差异;然而,心包积液中有无恶性细胞并不影响预后。(4) 结论:在需要经皮心包穿刺术治疗的大量心包积液患者中,恶性肿瘤相关心包积液、鼻咽癌和口咽癌以及转移状态是1年死亡率的阳性预测因素。在恶性肿瘤患者中,有转移患者的全因死亡率较高,但心包积液中有恶性细胞组和无恶性细胞组之间无差异。