Background
For the management of pericardial effusion, pericardiocentesis plays an essential role. Despite advanced imaging methods, a substantial risk of complication persists.
Objectives
We aimed to predict the risk factors of pericardiocentesis complicated by cardiac injury and to assess the surgical outcome in complicated cases after echo-guided drainage.
Patients and methods
This observational study enrolled 134 patients with pericardial effusion who were scheduled for pericardiocentesis for drainage. The patients were divided into two groups: group I comprised 21 patients who required surgical intervention, and group II included 113 patients with successful uncomplicated pericardiocentesis.
Results
The mean age was 47.49 ± 16.38 years, and 52.2% were males. There were no significant differences between both groups regarding the patients’ characteristics. Hemodynamic instability was higher in the complicated (71.4%) than the noncomplicated (20.4%) group. Recurrent pericardiocentesis trials (≥2) were statistically higher in group I than group II (<0.0001). The most common ethology was uremia, with no statistically significant difference between both groups. Multivariate analysis revealed that hemodynamic instability, more than two pericardiocentesis trial, and loculated effusion could predict cardiac injury during pericardiocentesis (odds ratio and 95% confidence interval were 24.206 and 3.632–161.315, 212.227, and 16.049–2806.445, and 16.113 and 1.765–147.058, respectively).
Conclusions
The presence of loculated effusion, hemodynamic instability, and the recurrence of effusion as two or more pericardiocentesis trials were potential risk factors of cardiac injury during pericardiocentesis. A pericardial window in high-risk cases is advised as a safe treatment procedure.