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Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

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EuroSCORE is a Predictor of Postoperative Pericardial Effusion following Heart Transplantation

Tomasz Urbanowicz, Ewa Staburzyńska-Migaj, Magdalena Pawłowska, Bartosz Żabicki, Michał Michalak, Marlena Filipiak, Stefan Grajek, Marek Jemielity

(Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland)

Ann Transplant 2015; 20:193-197

DOI: 10.12659/AOT.892582


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.
Material and 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±26×10^9/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.

Keywords: Heart Transplantation, Morbidity, Pericardial Effusion, Postoperative Complications, Risk Factors

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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