Abstract 17295: Predictors of Adverse Events in Patients with Postpericardiotomy Syndrome Following Cardiac Surgery
Background: Post-pericardiotomy syndrome (PPS) is relatively common and troublesome complication following cardiac surgery. Criteria for the diagnosis of PPS have been suggested in previous studies. It can occur a few days to several weeks following cardiac surgery and patients who fail medical therapy with anti-inflammatory medications are at risk for future adverse events.
Hypothesis: To identify clinical risk factors that may predict which patients with PPS may have a high likelihood of experiencing adverse events which include: recurrent pericarditis, pericardial effusion, and need for pericardiocentesis, pericardial window, or pericardiectomy.
Methods: We examined 239 consecutive patients who developed PPS after cardiac surgery from 2007-2010 (table). Logistic regression was used to examine univariate predictors of adverse events. Significant univariate predictors were added to the multivariable model in a step-wise fashion to identify the most significant predictors of adverse events among individuals with PPS.
Results: Out of 239 patients (mean age, 58±16, 72% male) with PPS (mean time to diagnosis 27±18 days), 75 (31.1%) patients experienced significant adverse events. Younger age, pericardial effusion size, and post-operative NYHA class III-IV were significant univariate predictors (p<0.05). The combined use of NSAIDs, colchicine, and corticosteroids (triple-therapy) was associated with a reduced risk of adverse events. In a multivariable model, triple-therapy was a negative predictor but younger age, effusion size, and pericardial constriction were associated with increased risk of developing adverse events (p<0.05).
Conclusions: This study identifies younger age, post-operative constriction, and failure to use triple-therapy as predictors of increased risk of adverse events and pericardial intervention among patients with PPS following cardiac surgery.
- © 2011 by American Heart Association, Inc.