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Background: Percutaneous pericardiocentesis represents a salvage procedure in case of cardiac tamponade and diagnostic procedure in chronic pericardial effusion of unknown source. The study aimed to analyze the clinical characteristics of patients subject to pericardiocentesis and the predictors of in-hospital mortality. Methods: The study represents a registry that covered consecutive patients undergoing percutaneous pericardiocentesis from 2011 to 2022 in high-volume tertiary reference center. Electronic health records were queried to obtain demographic and clinical variables. The primary endpoint was in-hospital mortality, while secondary endpoint was the need for recurrent pericardiocentesis. Results: Out of 132 456 patients hospitalized in the prespecified period, 247 patients were subject to percutaneous pericardiocentesis (53.9% women; median age of 66 years) who underwent 273 procedures. In-hospital death was reported in 14 patients (5.67%), while recurrent pericardiocentesis in 24 patients (9.72%). Iatrogenic cause was the most common etiology (42.5%), followed by neoplastic disease (23.1%) and idiopathic effusion (14.57%). In logistic regression analysis in-hospital mortality was associated with myocardial infarction (MI)-related etiology (p = 0.001) and recurrent/persistent cardiogenic shock (p = 0.001). Conclusions: Iatrogenic etiology and neoplastic disease seem to be the most common indications for pericardiocentesis, while in-hospital mortality was particularly high in patients with spontaneous tamponade in the course of MI.
RESUMO
BACKGROUND Surgery continues to play an important role in the treatment of ulcerative colitis (UC), which is one of the most common inflammatory diseases of the colon and rectum. This retrospective study from a single center in Poland aimed to evaluate surgical outcomes in 62 patients with ulcerative colitis. MATERIAL AND METHODS The study enrolled 62 patients (36 men [58.1%], 26 women [41.9%]), mean age 52.69±16.84 (range, 19-96) years who underwent surgical treatment of UC during the period 2001-2020. The mandatory inclusion criteria were patients with UC, who underwent total intra-abdominal colectomy (n=22, 46.8%), proctocolectomy (n=25, 53.2%), or left-sided hemicolectomy (n=8, 12.9%). The primary endpoint was postoperative death, and secondary endpoints were long hospitalization (>15 days), complications, and relaparotomy. RESULTS Postoperative mortality was observed in 8 (12.9%) patients. Older age and low albumin level were associated with longer hospitalization time (P=0.004 and P<0.001, respectively). High C-reactive protein (CRP) level (P=0.003), high CRP/albumin ratio (P=0.023), and malnourishment (P=0.026) were risk factors for complications. Malnutrition (P=0.026), older age (P=0.031), high CRP level (p<0.001), high CRP/albumin ratio (P=0.014), arterial hypertension (P=0.012), and urgent surgeries (P=0.021) were associated with higher risk of postoperative death. Patients who had undergone previous surgeries were more likely to need relaparotomy (P=0.022). CONCLUSIONS Preoperative nutritional status was an important factor associated with postoperative outcomes in patients with ulcerative colitis. Correction of malnutrition seems to be a vital part of preoperative preparation.
