CONSTRICTIVE PERICARDITIS AND ASCITES: A CROSS-SECTIONAL STUDY

Abstract

SESSION TITLE: Cardiothoracic Surgery Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Constrictive pericarditis is a rare disease with various causes and manifestations. Our study evaluated clinical features, length of stay (LOS) and costs among patients admitted with constrictive pericarditis in a large nationally representative database. METHODS: We conducted a retrospective study of patients who were discharged from the acute care hospitals in the United States from 2012 to 2014. Based on Healthcare Cost and Utilization Project NIS database. ICD-9-CM was used to identify all diagnosis variables. Procedure Clinical Classification Software (CCS) codes were used for all procedures of interest. We compared baseline demographics, hospital characteristics and comorbidities of patients greater than 18 years old with comorbidity of ascites admitted with constrictive pericarditis. We sub-grouped patients with a principal diagnosis of constrictive pericarditis to 2 cohorts with or without ascites during hospitalization. RESULTS: There were 3,415 adult admissions with a principal diagnosis of constrictive pericarditis in the study period, among which 31% were female, 79.1% were Caucasian. The mean age was 59.9. For clinical presentations, 19.3% had a diagnosis of ascites. 9.6% (n=330) had cardiac tamponade, 33.9% had pleural effusion. 36.9% had atrial fibrillation. For constrictive pericarditis related and comorbidities, 57.2% had hypertension, 31.7% had coronary artery disease, 22.1% had chronic kidney disease (CKD), 48% had congestive heart failure, 2% had cirrhosis, 0.4% had tuberculosis, 0.4% had sarcoidosis. 1.3% had systemic lupus erythematosus (SLE). Of all the patients with a principal diagnosis of constrictive pericarditis, 29.7% underwent cardiac catheterization, 10.5% underwent pericardiocentesis. 42.6% (n=1455) underwent pericardiectomy. Among which 485 cases were performed with cardiopulmonary bypass (CPB). Patients with ascites are more likely to be male (78.0% vs. 66.8%, p<0.05), while less likely had cardiac tamponade [(3.8% vs. 11.1%, adjusted odds ratio (aOR) 0.32, 95% CI 0.12- 0.85, p<0.05]. In-patient mortality was 4.9% (n=170). The mean length of stay (LOS) was 10.1 days. The total cost was $35,007. Compare with patients without ascites, patients with ascites had a significantly longer LOS (difference of 4 days, p<0.05) and higher cost (additional $17382, p<0.05) after adjusting for patient and hospital-level confounders. There was no statistical difference in mortality between the two groups. CONCLUSIONS: Patients with ascites are more likely to be male and less likely had cardiac tamponade. Concomitant diagnosis of ascites in patients admitted with constrictive pericarditis as a principal diagnosis is associated with higher length of stay and cost. CLINICAL IMPLICATIONS: Patients with constrictive pericarditis who developed ascites may reflect a later stage of right heart failure. Early recognition and prompt treatment may alleviate the health care burden. DISCLOSURES: No relevant relationships by Si Li, source=Web Response No relevant relationships by Bojana Milekic, source=Web Response No relevant relationships by Fareeha Mubin, source=Web Response No relevant relationships by Pius Ochieng, source=Web Response No relevant relationships by Palakkumar Patel, source=Web Response No relevant relationships by NISHANT SHARMA, source=Web Response No relevant relationships by Yichen Wang, source=Web Response