title: Cardiac tamponade: an initial study in the development of a predictive tool.
abstract: This exploratory study was conducted over a 12-month period to describe the relationship between selected clinical variables and the occurrence of postoperative cardiac tamponade. Data were collected on 19 variables. A total of 739 patients were included in the study. A postoperative diagnosis of cardiac tamponade was made in nine of these patients who then comprised the tamponade group. A matched non-tamponade control group of 18 patients was identified for comparison. The following were found to be significantly different in a statistical comparison between variable values in the tamponade and non-tamponade groups: (1) serum creatinine level (p = 0.005), (2) chest tube drainage (p = 0.009), (3) sustained pressure plateau (p = .018), and (4) mediastinal widening (p = 0.039). Two additional variables, pulsus paradoxus and elevated BUN, appeared to be of value in the assessment of late tamponade. Discriminant analysis showed a high predictive accuracy of the above combined variables. Such results warrant the further investigation of these variables in other clinical settings. Both a replication and testing of a tamponade score system would be a fertile and necessary area of research for critical care nurses who provide care for post-cardiac surgery patients. These data suggest that equal weight be assigned to each of the four variables. Thus scores would range from 0 to 4; higher scores would represent greater risk (Table III). With further investigation of this area of clinical practice, the identification of patients at higher risk for tamponade could be greatly facilitated.
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000175:diagnosis*; D003404:Creatinine / Q000097:blood; D004322:Drainage; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies
chemical_list: D003404:Creatinine