Risk Factors Associated with Mortality After Pericardial Window in Hospitalized Patients - A Retrospective Analysis.

Introduction: Chronic pericardial effusion is a common pericardial syndrome associated with multiple etiologies. Most studies report good outcomes and success rate after pericardial window, although mortality varies. This study aimed to identify risk predictors for mortality in addition to determining factors associated with in-hospital mortality over a 30-day period in patients who underwent surgical pericardial window.

Methods: We retrospectively reviewed case files from patients who underwent pericardial window for the treatment of pericardial effusion from 2007 to 2023.

Results: One hundred and two patients were included in our analysis, with an overall hospitalized mortality after pericardial window of 28% (n = 29). When assessing etiology, mortality was similar between all causes of effusion (P = 0.359). In echocardiography, there was a significantly lower left ventricular ejection fraction (P = 0.016) in patients who died after the surgical procedure. Similarly, the presence of cardiac cavity collapse before the procedure was significant for an increase in mortality (P ≤ 0.0001). Logistic and Cox regression analysis showed that cardiac cavity collapse, complications, and lung cancer were associated with increased postoperative mortality following pericardial window.

Conclusion: Although surgical pericardial window offers feasible treatment with good success rates, in-hospital mortality is elevated, particularly in patients with cardiac cavity collapse and complications.