Abstract 19557: Comparative In-Hospital Outcomes for Pericardiocentesis versus Surgical Pericardiotomy in United States
Background: The national and comparative in-hospital outcomes and resource utilization for pericardiocentesis and surgical pericardiotomy are not known.
Methods: The Nationwide Inpatient Sample (NIS) database was used to identify patients who underwent pericardiocentesis or pericardiotomy from 2005 to 2009 in the United States. We used propensity score matching and the Elixhauser index for comorbidity adjustment to compare in-hospital outcomes and resource utilization among matched groups of patients that underwent either pericardiocentesis or pericardiotomy.
Results: Among a total of 131,945 patients who underwent either procedure during the study period, 17,565 patients were divided into two matched groups of pericardiocentesis (9,336 patients) and pericardiotomy (8,229 patients). The pericardiocentesis group had significantly higher in-hospital mortality than the pericardiotomy group (15.7% vs. 10.4%, p<0.001). Patients in the pericardiotomy group had a significantly higher rate of blood transfusions (22.6% vs. 19.5%, p<0.001), post-procedural respiratory complications (2.0% vs. 0.8%, p<0.001), iatrogenic pneumothorax (8.1% vs. 3.1%, p<0.001), post-operative hemorrhage (3.1% vs. 1.8%, p<0.001), and post-operative hematoma (1.5% vs. 1.0%, p=0.001). The average length of stay was longer in the pericardiotomy group than in the pericardiocentesis group (12.6 vs. 8.5 days, p <0.001). The average hospital charges were also higher in the pericardiotomy group than in the pericardiocentesis group ($108,624 vs. $75,690, p<0.001).
Conclusion: In this observational study, we found that pericardiocentesis is associated with a significantly higher in-hospital mortality than surgical pericardiotomy while the latter is associated with higher rates of post-operative morbidity and resource utilization.
- © 2012 by American Heart Association, Inc.