title: Pericardiocentesis adverse event risk factors: a nationwide population-based cohort study.
abstract: OBJECTIVE
  Echocardiography-guided pericardiocentesis has been the leading procedure for diagnosis and therapy of pericardial effusion. We aimed to identify risk factors for recurrence, complications, and mortality in pericardial effusion patients treated with pericardiocentesis.
  
  
  METHODS
  We identified and collected data from 8,101 patients receiving pericardiocentesis between 1997 and 2010 from the Taiwan National Health Insurance Research Database. A multivariate regression model was used to investigate risk factors for recurrence, complications, and death.
  
  
  RESULTS
  There were 8,565 admissions among 8,101 patients. The most common underlying condition was malignancy (41%), especially lung cancer (23%), tuberculosis (9.0%), and acute pericarditis (8.2%). Surgical drainage was required in 12.7% of cases. Recurrence was more likely in patients with malignancy (HR 2.20, p < 0.001), but complications were less likely (OR 0.52, p = 0.003). In-hospital death numbers and complication risks (OR 2.38, p < 0.001; OR 1.27, p = 0.01) were greater in the catheter-related cardiac procedure group than in the other groups.
  
  
  CONCLUSIONS
  Malignant neoplasms and catheter-based cardiac procedures have become major risk factors for adverse events in patients receiving pericardiocentesis in Taiwan. Malignancy leads to an increase in recurrence and in-hospital mortality but is associated with a lower rate of acute complications. Cardiac catheterization procedures and surgery increase both complications and in-hospital mortality.
authors.affiliation: Division of Cardiology, Chang-Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Ming-Yun
authors.initials: MY
authors.lastname: Ho
authors.forename: Jian-Liang
authors.initials: JL
authors.lastname: Wang
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Chun-Tai
authors.initials: CT
authors.lastname: Mao
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Tsai
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.forename: Chao-Yung
authors.initials: CY
authors.lastname: Wang
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
authors.forename: Tien-Hsing
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010490:Pericardial Effusion / Q000601:surgery*; D020519:Pericardiocentesis / Q000009:adverse effects*; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult