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Essay On Inpatient Mortality

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We conducted an analysis of national inpatient sample, the largest all-payer inpatient database of the United States, to estimate the incidence of in-patient mortality after pericardiocentesis in all comers, and in subgroup of patients with coexisting cardiac procedures associated with iatrogenic pericardial effusion. Furthermore, we also studied the relationship between the hospital procedure volume and inpatient mortality after pericardiocentesis. To our knowledge, this is the first analysis of its kind of a nationally representative data of the United States. We found the estimated in-patient mortality of patients undergoing pericardiocentesis is higher than previously reported single center studies (2-6, 8-9). Approximately, one in…show more content…
Thirdly, our patient population has differences compared to prior studies. Our patient population was older and higher proportion of patients were unstable compared to previous studies (2,6,8). Similar to prior studies about one third of patients had malignancy, however, the prevalence of percutaneous cardiac procedures in patients undergoing pericardiocentesis have increased significantly (2-3,8).
With continued increase in the use as well as complexity of the percutaneous cardiac procedures, iatrogenic pericardial effusion will likely to remain one of the common reasons for pericardiocentesis (11). The rapid increase in pericardial pressure due to acute onset, in patients who are usually anticoagulated, is more likely to be associated with hemodynamic collapse and death in the absence of urgent intervention compared to chronic large effusion. Catheter based percutaneous cardiac procedures were performed during the same hospitalization in about 17.77% of patients undergoing pericardiocentesis in our analysis, and most of these procedures were electrophysiologic consistent with prior studies (5,11). As expected the subgroup of pericardiocentesis patients who underwent PCI and structural heart interventions had significantly higher inpatient mortality compared to controls. About one in four such patients died during the hospitalization (Figure 1).
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