Abstract 14541: Pericardiocentesis is Associated With Higher Mortality in Patients With Pulmonary Hypertension

Abstract

Background: Pericardiocentesis in patients with Pulmonary Hypertension (PH) and pericardial effusions has unclear benefits, as it has been associated with acute hemodynamic collapse and increased mortality. Data on in-hospital outcomes in this population is limited. Aims. Describe pericardiocentesis-related patient characteristics and in-hospital outcomes in patients with PH versus without. Methods: The National Inpatient Sample database was used to identify adult patients undergoing pericardiocentesis during hospitalizations between 2016 and 2020. Data were stratified between patients with and without PH. A multivariate regression model was used to estimate the association of PH with pericardiocentesis in-hospital outcomes, adjusting for statistically significant comorbidities. Results: A total of 95,665 hospitalizations with a procedure diagnosis of pericardiocentesis were included, of which 7,770 had PH. Patients with PH tended to be older (67 ± 15.7) and female (56%), had significantly higher rates of hypertension (79% vs 66%, P<0.01), diabetes (26% vs 17%, P<0.01), chronic lung disease (32% vs 23%, P<0.01), chronic liver disease ( 15% vs 12%, P<0.01), CKD ( 44% vs 25%, P<0.01), and chronic heart failure (19% vs 10%, P<0.01). Pericardiocentesis in PH was associated with higher in-hospital all-cause mortality, post-procedure shock, cardiogenic shock, cardiac arrest, and mechanical circulatory support compared to patients without PH. Those presenting with cardiac tamponade had higher odds of mortality, post-procedural shock, and mechanical circulatory support (Figure 1) compared to patients without PH. All P values were < 0.001. Conclusion: PH was associated with higher mortality and a higher rate of cardiovascular complications in patients undergoing pericardiocentesis. Those presenting with tamponade had particularly worse outcomes. Further research on the outcomes of pericardiocentesis in these patients is needed.