title: EuroSCORE is a predictor of postoperative pericardial effusion following heart transplantation.
abstract: BACKGROUND
  Pericardial effusion is an early complication following orthotopic heart transplantation. Effusion that requires surgical intervention not only prolongs in-hospital stay but also increases early mortality rate. EuroSCORE is one of the most common methods for calculating predictive mortality in heart surgery.
  
  
  METHODS
  We performed a retrospective analysis of 25 patients (22 men and 3 women, mean age 49±12 years). Mortality risk by EuroSCORE was estimated prior to surgery. All patients were operated on with Lower-Shumway technique and treated with standard triple immunosuppressive regimen (tacrolimus, mycophenolate mofetil, and prednisolone). They were divided into 2 groups depending on postoperative pericardial effusion that required surgical intervention. There were 9 (36%) patients in the pericardial effusion group (PE group) and 16 (64%) in the control group (C group).
  
  
  RESULTS
  There was 1 death, on the 7th postoperative day, due to Clostridium difficile infection. Mean time of pericardial effusion echocardiographic detection was 9±2 days following surgery. The mean amount of fluid diagnosed in 4-chamber transthoracic echocardiography was 2.2±0.3 cm vs. 0.7±0.2 cm (p<0.05). Pericardial effusion followed thrombocytopenia of 98±17 vs. 172±26×10⁹/L in PE and C group (p<0.05). Patients' mean intensive care unit time stay was 23±9 days and 11±7 days in PE and C group, respectively (p<0.05). The overall hospitalization time was 38±12 days and 31±23 days in PE and C group, respectively (p<0.05). The discriminant analysis showed that EuroSCORE >16% is a single predicting variable for postoperative pericardial effusion (AUC 0.946, CI: 0.76-0.99).
  
  
  CONCLUSIONS
  Pericardial effusion is a common (36%) complication following heart transplantation. It requires surgical intervention and prolongs intensive care unit stay and overall hospitalization. The discriminant analysis showed that the EuroSCORE >16% is a single predicting variable for postoperative pericardial effusion.
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbanowicz
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Staburzyńska-Migaj
authors.affiliation: Cardiac Surgery and Transplantology Department, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Pawłowska
authors.affiliation: Department of Radiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Żabicki
authors.affiliation: Department of Biostatistics, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Michalak
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Marlena
authors.initials: M
authors.lastname: Filipiak
authors.affiliation: Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
authors.affiliation: Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Jemielity
mesh_terms: D000328:Adult; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000209:etiology*; D011184:Postoperative Period; D012189:Retrospective Studies