title: Incidence and risk factors of postpericardiotomy syndrome requiring medical attention: The Finland postpericardiotomy syndrome study.
abstract: OBJECTIVE
  Postpericardiotomy syndrome is a well-known complication after cardiac surgery. Nevertheless, little is known about the incidence and predictors of postpericardiotomy syndrome requiring medical attention or hospitalization in a contemporary set of patients undergoing isolated coronary bypass.
  
  
  METHODS
  This retrospective analysis included 688 patients from 2008 to 2010. The median follow-up time was 5.3 [4.5-6.0] years.
  
  
  RESULTS
  The incidence of postpericardiotomy syndrome was 61 of 688 patients (8.9%), and the median time to diagnosis was 21 [11-52] days, but only 13 patients (22%) required pleural drainage and 3 patients (4.9%) required pericardiocentesis. Patients with postpericardiotomy syndrome more often had 1 or more red blood cell units transfused (61% vs 43%, P = .008) after surgery and less often had diabetes (12% vs 31% P = .002) or metformin medication (3.3% vs 20%, P = .001) compared with those without postpericardiotomy syndrome. In multivariable Cox regression model, renal insufficiency and 1 or more red blood cell units transfused remained as independent predictors of postpericardiotomy syndrome and diabetes remained as a protective factor. Incidence of recurrences was high (38%), and increasing body mass index was the only predictor of relapse.
  
  
  CONCLUSIONS
  The incidence of symptomatic postpericardiotomy syndrome leading to medical care contact was markedly lower compared with that reported in older clinical studies. Postpericardiotomy syndrome was associated with the use of red blood cell units and was less common in patients with medically treated diabetes.
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Joonas
authors.initials: J
authors.lastname: Lehto
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland; Departments of Surgery and Internal Medicine, University of Turku, Turku, Finland. Electronic address: jarmo.gunn@tyks.fi.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Gunn
authors.affiliation: Heart Center, Satakunta Central Hospital, Pori, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Karjalainen
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Airaksinen
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kiviniemi
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology; D004322:Drainage; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D010492:Pericardiectomy / Q000009:adverse effects*; D020519:Pericardiocentesis; D011185:Postpericardiotomy Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016016:Proportional Hazards Models; D012008:Recurrence; D051437:Renal Insufficiency / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin