Incidence, risk factors and clinical outcomes of pericardial effusion in left ventricular assist device patients.

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Muhammad Zubair Khan, Yevgeniy Brailovsky, Mohammad Alfrad Nobel Bhuiyan, Gregary Marhefka, Abu S M Faisal, Adrija Sircar, Parker O'Neill, J Eduardo Rame, Sona Franklin, Muhammad Waqas, Hadia Shah, Indranee Rajapreyar, Rene J Alvarez
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引用次数: 0

Abstract

Background: Development of pericardial effusion in patients with left ventricular assist devices (LVADs) can be detrimental to health outcomes. This study aims to elucidate the prevalence and risk factors for pericardial effusion in patients with LVADs.

Aim: To elucidate risk factors associated with the presence of pericardial effusion in patients with LVADs and compare the clinical outcomes of those with and without pericardial effusion. The secondary goal is to determine the incidence of pericardiocentesis and pericardial window placement in patients with LVADs experiencing pericardial effusion.

Methods: Data were obtained from the National Inpatient Sample database between 2016 and 2018. Statistical analysis was performed using Pearson χ 2 test and multivariate logistic regression analysis to determine clinical outcomes of pericardial effusion and to identify variables associated with pericardial effusion in LVAD patients, respectively.

Results: The prevalence of LVAD was 9850 (0.01%) among total study patients (n = 98112095). The incidence of pericardial effusion among LVAD patients was 640 (6.5%). The prevalence of liver disease (26.6% vs 17.4%), chronic kidney disease (CKD; 54.6% vs 49.4%), hypothyroidism (21.9% vs 18.1%), congestive heart failure (98.4% vs 96.5%), atrial fibrillation (Afib; 58.59% vs 50.5%), coronary artery disease (CAD; 11.7% vs 4.4%), dyslipidemia (31.3% vs 39.3%), and having undergone percutaneous coronary intervention (PCI; 1.6% vs 0.7%) was higher in the pericardial effusion cohort vs the non-pericardial effusion cohort. Multivariate regression analysis demonstrated that CAD (OR = 2.89) and PCI (OR = 2.2) had the greatest association with pericardial effusion in patients with LVADs. These were followed by liver disease (OR = 1.72), hypothyroidism (OR = 1.2), electrolyte derangement (OR = 1.2), Afib (OR = 1.1), and CKD (OR = 1.05). Among patients with LVADs, the median length of stay (33 days vs 27 days) and hospitalization cost (847525 USD vs 792616 USD) were significantly higher in the pericardial effusion cohort compared to the non-pericardial effusion cohort. There was no significant difference in mortality between cohorts. The prevalence of cardiac tamponade was 109 (17.9% of LVAD patients with pericardial effusion). Ten (9.2% of LVAD patients with cardiac tamponade) patients underwent pericardiocentesis and 44 (40.3%) received a pericardial window.

Conclusion: This study shows that liver disease, CKD, PCI, hypothyroidism, electrolyte derangement, Afib, and CAD had a significant association with pericardial effusion in LVAD patients. Hospitalization cost and length of stay were higher in the pericardial effusion group, but mortality was the same.

左心室辅助装置患者心包积液的发生率、危险因素及临床结局。
背景:使用左心室辅助装置(lvad)患者心包积液的发展可能对健康结果有害。本研究旨在探讨lvad患者心包积液的患病率及危险因素。目的:探讨与lvad患者心包积液相关的危险因素,并比较有和无心包积液患者的临床结果。次要目的是确定发生心包积液的lvad患者心包穿刺和心包窗置入的发生率。方法:数据来自2016 - 2018年全国住院患者样本数据库。采用Pearson χ 2检验和多因素logistic回归分析,分别确定LVAD患者心包积液的临床结局和确定与心包积液相关的变量。结果:总研究患者中LVAD患病率为9850例(0.01%)(n = 98112095)。LVAD患者心包积液发生率为640(6.5%)。肝病患病率(26.6% vs 17.4%)、慢性肾脏疾病(CKD;54.6%对49.4%),甲状腺功能减退(21.9%对18.1%),充血性心力衰竭(98.4%对96.5%),心房颤动(Afib;58.59% vs 50.5%),冠状动脉疾病(CAD;11.7% vs 4.4%),血脂异常(31.3% vs 39.3%),接受过经皮冠状动脉介入治疗(PCI;(1.6% vs 0.7%)在心包积液组高于非心包积液组。多因素回归分析显示,CAD (OR = 2.89)和PCI (OR = 2.2)与lvad患者心包积液的相关性最大。其次是肝病(OR = 1.72)、甲状腺功能减退(OR = 1.2)、电解质紊乱(OR = 1.2)、Afib (OR = 1.1)和CKD (OR = 1.05)。在lvad患者中,心包积液组的中位住院时间(33天vs 27天)和住院费用(847525美元vs 792616美元)明显高于非心包积液组。队列之间的死亡率没有显著差异。心包填塞发生率为109例(17.9%为伴有心包积液的LVAD患者)。10例(9.2%)LVAD合并心包填塞患者行心包穿刺,44例(40.3%)行心包开窗。结论:本研究显示肝脏疾病、CKD、PCI、甲状腺功能减退、电解质紊乱、Afib和CAD与LVAD患者心包积液有显著相关性。心包积液组住院费用和住院时间较高,但死亡率相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Cardiology
World Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.30%
发文量
54
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