Clinical Features Associated With Adverse Events in Patients With Post-Pericardiotomy Syndrome Following Cardiac Surgery
Postpericardiotomy syndrome (PPS) may be associated with tamponade and pericardial constriction that may require procedural intervention. The aim of this study was to identify clinical features associated with adverse events requiring procedural intervention in patients with PPS. A total of 239 pati...
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| Veröffentlicht in: | The American journal of cardiology 2014-11, Vol.114 (9), p.1426-1430 |
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| container_title | The American journal of cardiology |
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| creator | Alraies, M. Chadi, MD Al Jaroudi, Wael, MD Shabrang, Cyrus, MD Yarmohammadi, Hirad, MD, MPH Klein, Allan L., MD Tamarappoo, Balaji K., MD, PhD |
| description | Postpericardiotomy syndrome (PPS) may be associated with tamponade and pericardial constriction that may require procedural intervention. The aim of this study was to identify clinical features associated with adverse events requiring procedural intervention in patients with PPS. A total of 239 patients who developed PPS after cardiac surgery were monitored for 12 months. PPS was diagnosed if 2 of the 5 following findings were present: fever without infection, pleuritic pain, friction rub, pleural effusion, and pericardial effusion ( |
| doi_str_mv | 10.1016/j.amjcard.2014.07.078 |
| format | Article |
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Chadi, MD ; Al Jaroudi, Wael, MD ; Shabrang, Cyrus, MD ; Yarmohammadi, Hirad, MD, MPH ; Klein, Allan L., MD ; Tamarappoo, Balaji K., MD, PhD</creator><creatorcontrib>Alraies, M. Chadi, MD ; Al Jaroudi, Wael, MD ; Shabrang, Cyrus, MD ; Yarmohammadi, Hirad, MD, MPH ; Klein, Allan L., MD ; Tamarappoo, Balaji K., MD, PhD</creatorcontrib><description>Postpericardiotomy syndrome (PPS) may be associated with tamponade and pericardial constriction that may require procedural intervention. The aim of this study was to identify clinical features associated with adverse events requiring procedural intervention in patients with PPS. A total of 239 patients who developed PPS after cardiac surgery were monitored for 12 months. PPS was diagnosed if 2 of the 5 following findings were present: fever without infection, pleuritic pain, friction rub, pleural effusion, and pericardial effusion (<60 days after surgery). The primary end point was the development of pericardial effusion or pericardial constriction requiring procedural intervention. Among 239 patients with PPS, 75 (31%) required procedural intervention. In a univariate analysis, the odds of a procedural intervention were decreased with older age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.96 to 0.99) and with colchicine used in combination with anti-inflammatory agents (OR 0.45, 95% CI 0.26 to 0.79). However, the odds were increased in patients with preoperative heart failure (OR 1.84, 95% CI 1 to 3.39) and early postoperative constrictive physiology (OR 5.77, 95% CI 2.62 to 12.7). After multivariate adjustment, treatment with colchicine along with anti-inflammatory agents was associated with lower odds of requiring intervention (OR 0.43, 95% CI 0.95 to 0.99). Independent positive predictors of procedural intervention included age (OR 0.97, 95% CI 0.95 to 0.99), time to PPS (OR 0.97, 95% CI 0.95 to 0.99), and early postoperative constrictive physiology (OR 6.23, 95% CI 2.04 to 19.07). In conclusion, younger age, early-onset PPS, and postoperative constrictive physiology were associated with the need for procedural intervention in patients with PPS, whereas colchicine was associated with reduced odds of adverse events and procedural intervention.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2014.07.078</identifier><identifier>PMID: 25306427</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Cardiac Surgical Procedures - adverse effects ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Confidence intervals ; Coronary vessels ; Echocardiography ; Female ; Fever ; Follow-Up Studies ; Heart failure ; Heart surgery ; Humans ; Intervention ; Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; NMR ; Nonsteroidal anti-inflammatory drugs ; Nuclear magnetic resonance ; Pain ; Pericardiocentesis - methods ; Physiology ; Postoperative Complications ; Postoperative period ; Postpericardiotomy Syndrome - diagnosis ; Postpericardiotomy Syndrome - etiology ; Postpericardiotomy Syndrome - surgery ; Prognosis ; Retrospective Studies ; Surgical outcomes ; Variables</subject><ispartof>The American journal of cardiology, 2014-11, Vol.114 (9), p.1426-1430</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 1, 2014</rights><rights>2014 Elsevier Inc. All rights reserved. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c550t-60dfc8ece9a2d2239f13062bd9f402fbe3664c17c2f18ea7d524668a94ef10d33</citedby><cites>FETCH-LOGICAL-c550t-60dfc8ece9a2d2239f13062bd9f402fbe3664c17c2f18ea7d524668a94ef10d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1614422783?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25306427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alraies, M. Chadi, MD</creatorcontrib><creatorcontrib>Al Jaroudi, Wael, MD</creatorcontrib><creatorcontrib>Shabrang, Cyrus, MD</creatorcontrib><creatorcontrib>Yarmohammadi, Hirad, MD, MPH</creatorcontrib><creatorcontrib>Klein, Allan L., MD</creatorcontrib><creatorcontrib>Tamarappoo, Balaji K., MD, PhD</creatorcontrib><title>Clinical Features Associated With Adverse Events in Patients With Post-Pericardiotomy Syndrome Following Cardiac Surgery</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Postpericardiotomy syndrome (PPS) may be associated with tamponade and pericardial constriction that may require procedural intervention. The aim of this study was to identify clinical features associated with adverse events requiring procedural intervention in patients with PPS. A total of 239 patients who developed PPS after cardiac surgery were monitored for 12 months. PPS was diagnosed if 2 of the 5 following findings were present: fever without infection, pleuritic pain, friction rub, pleural effusion, and pericardial effusion (<60 days after surgery). The primary end point was the development of pericardial effusion or pericardial constriction requiring procedural intervention. Among 239 patients with PPS, 75 (31%) required procedural intervention. In a univariate analysis, the odds of a procedural intervention were decreased with older age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.96 to 0.99) and with colchicine used in combination with anti-inflammatory agents (OR 0.45, 95% CI 0.26 to 0.79). However, the odds were increased in patients with preoperative heart failure (OR 1.84, 95% CI 1 to 3.39) and early postoperative constrictive physiology (OR 5.77, 95% CI 2.62 to 12.7). After multivariate adjustment, treatment with colchicine along with anti-inflammatory agents was associated with lower odds of requiring intervention (OR 0.43, 95% CI 0.95 to 0.99). Independent positive predictors of procedural intervention included age (OR 0.97, 95% CI 0.95 to 0.99), time to PPS (OR 0.97, 95% CI 0.95 to 0.99), and early postoperative constrictive physiology (OR 6.23, 95% CI 2.04 to 19.07). In conclusion, younger age, early-onset PPS, and postoperative constrictive physiology were associated with the need for procedural intervention in patients with PPS, whereas colchicine was associated with reduced odds of adverse events and procedural intervention.</description><subject>Age</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Confidence intervals</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Fever</subject><subject>Follow-Up Studies</subject><subject>Heart failure</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Intervention</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Nuclear magnetic resonance</subject><subject>Pain</subject><subject>Pericardiocentesis - methods</subject><subject>Physiology</subject><subject>Postoperative Complications</subject><subject>Postoperative period</subject><subject>Postpericardiotomy Syndrome - diagnosis</subject><subject>Postpericardiotomy Syndrome - etiology</subject><subject>Postpericardiotomy Syndrome - surgery</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgical outcomes</subject><subject>Variables</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUk1vEzEQtRCIhsJPAFniwmWDv_brUhRFTUGqRKSAOFqOPZt62V0X2xvIv6-3CQV6QRrJY82b5zd-g9BrSuaU0OJ9O1d9q5U3c0aomJMyRfUEzWhV1hmtKX-KZoQQltVU1GfoRQhtulKaF8_RGcs5KQQrZ-jXsrOD1arDK1Bx9BDwIgSnrYpg8Dcbb_DC7MEHwJd7GGLAdsBrFe19fl9fuxCzNXg7qbEuuv6AN4fBeNcDXrmucz_tsMPLqao03ox-B_7wEj1rVBfg1ek8R19Xl1-WH7Prz1eflovrTOc5iVlBTKMr0FArZhjjdUOTdLY1dSMIa7bAi0JoWmrW0ApUaXImiqJStYCGEsP5Obo48t6O2x6MTrq96uStt73yB-mUlf9WBnsjd24vBaeJqEwE704E3v0YIUTZ26Ch69QAbgySFjQF55wk6NtH0NaNfkjjTSghGCurSVF-RGnvQvDQPIihRE7eylaevJWTt5KUKarU9-bvSR66fpuZAB-OAEj_ubfgZdDJJw3GetBRGmf_-8TFIwZ9Wo_vcIDwZxoZmCRyMy3YtF9UJM6U8ztitM7v</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Alraies, M. 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Chadi, MD</au><au>Al Jaroudi, Wael, MD</au><au>Shabrang, Cyrus, MD</au><au>Yarmohammadi, Hirad, MD, MPH</au><au>Klein, Allan L., MD</au><au>Tamarappoo, Balaji K., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Features Associated With Adverse Events in Patients With Post-Pericardiotomy Syndrome Following Cardiac Surgery</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>114</volume><issue>9</issue><spage>1426</spage><epage>1430</epage><pages>1426-1430</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Postpericardiotomy syndrome (PPS) may be associated with tamponade and pericardial constriction that may require procedural intervention. The aim of this study was to identify clinical features associated with adverse events requiring procedural intervention in patients with PPS. A total of 239 patients who developed PPS after cardiac surgery were monitored for 12 months. PPS was diagnosed if 2 of the 5 following findings were present: fever without infection, pleuritic pain, friction rub, pleural effusion, and pericardial effusion (<60 days after surgery). The primary end point was the development of pericardial effusion or pericardial constriction requiring procedural intervention. Among 239 patients with PPS, 75 (31%) required procedural intervention. In a univariate analysis, the odds of a procedural intervention were decreased with older age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.96 to 0.99) and with colchicine used in combination with anti-inflammatory agents (OR 0.45, 95% CI 0.26 to 0.79). However, the odds were increased in patients with preoperative heart failure (OR 1.84, 95% CI 1 to 3.39) and early postoperative constrictive physiology (OR 5.77, 95% CI 2.62 to 12.7). After multivariate adjustment, treatment with colchicine along with anti-inflammatory agents was associated with lower odds of requiring intervention (OR 0.43, 95% CI 0.95 to 0.99). Independent positive predictors of procedural intervention included age (OR 0.97, 95% CI 0.95 to 0.99), time to PPS (OR 0.97, 95% CI 0.95 to 0.99), and early postoperative constrictive physiology (OR 6.23, 95% CI 2.04 to 19.07). In conclusion, younger age, early-onset PPS, and postoperative constrictive physiology were associated with the need for procedural intervention in patients with PPS, whereas colchicine was associated with reduced odds of adverse events and procedural intervention.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25306427</pmid><doi>10.1016/j.amjcard.2014.07.078</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Age Cardiac Surgical Procedures - adverse effects Cardiology Cardiovascular Cardiovascular disease Confidence intervals Coronary vessels Echocardiography Female Fever Follow-Up Studies Heart failure Heart surgery Humans Intervention Magnetic Resonance Imaging, Cine Male Middle Aged NMR Nonsteroidal anti-inflammatory drugs Nuclear magnetic resonance Pain Pericardiocentesis - methods Physiology Postoperative Complications Postoperative period Postpericardiotomy Syndrome - diagnosis Postpericardiotomy Syndrome - etiology Postpericardiotomy Syndrome - surgery Prognosis Retrospective Studies Surgical outcomes Variables |
| title | Clinical Features Associated With Adverse Events in Patients With Post-Pericardiotomy Syndrome Following Cardiac Surgery |
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