Our Summary

This research project aimed to investigate the trends in complications, deaths in hospital, and readmissions after a type of heart surgery called pericardiectomy in the United States. The researchers used a large database of hospital readmissions to find patients who had this surgery between 2010 and 2019. They used statistical tests to look at death and readmission rates. The researchers also used a type of statistical modelling to identify factors that can predict death and readmission.

They found that a total of 26,169 patients had this surgery during the study period. The average age was 59 years and almost half were women. The death rate in hospital was 5.2% and the usual length of stay was 7 days. Factors that increased the chance of dying in hospital included being older, having more health issues, and the hospital performing fewer of these surgeries each year.

The rates of patients being readmitted to hospital 30 and 90 days after the surgery were 18% and 28% respectively. Factors that increased the chance of being readmitted included previous heart surgery, a diagnosis of a specific heart condition called constrictive pericarditis, and having more health issues.

In conclusion, the rates of this heart surgery have remained largely the same, with small changes in death and readmission rates over the last 10 years. Being older, the hospital performing fewer of these surgeries, and having more health issues can predict the chances of dying from the surgery.

FAQs

  1. What are the national trends in perioperative complications, in-hospital mortality, and readmissions after pericardiectomy based on the study?
  2. What factors were found to be independent predictors of in-hospital mortality and readmission after a pericardiectomy?
  3. Have the rates of isolated pericardiectomy changed significantly over the last decade?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to follow post-operative care instructions carefully to reduce the risk of complications and ensure a successful recovery. This may include taking prescribed medications, attending follow-up appointments, avoiding strenuous activities, and monitoring for any signs of infection or other complications. It is also important to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall heart health after surgery.

Suitable For

Patients who are typically recommended for pericardiectomy are those with constrictive pericarditis, recurrent pericardial effusion, or chronic constrictive pericarditis. Additionally, patients who have failed medical management or have significant symptoms such as shortness of breath, chest pain, or fatigue may also be candidates for pericardiectomy. Advanced age, higher co-morbidity index, and previous cardiac surgery may also play a role in determining the candidacy for pericardiectomy.

Timeline

  • Before pericardiectomy: Patients may experience symptoms such as chest pain, shortness of breath, fatigue, and swelling in the abdomen or legs. They may undergo various diagnostic tests such as echocardiography, MRI, and CT scans to confirm the diagnosis of pericardial disease.

  • Pericardiectomy procedure: During the surgery, the surgeon removes part or all of the pericardium (the sac surrounding the heart) to relieve pressure on the heart and improve its function.

  • After pericardiectomy: Patients may experience pain and discomfort at the surgical site, and they will be closely monitored in the hospital for any complications. They may also undergo physical therapy to help with recovery and regain strength. In some cases, patients may require further treatment or medications to manage symptoms and prevent complications.

What to Ask Your Doctor

  1. What is the success rate of pericardiectomy at your facility?
  2. How many pericardiectomy procedures does your facility perform annually?
  3. What are the potential complications and risks associated with pericardiectomy?
  4. What is the typical recovery time and post-operative care for patients undergoing pericardiectomy?
  5. Are there any alternative treatments or less invasive procedures that could be considered before opting for pericardiectomy?
  6. How will my overall health and any pre-existing conditions impact the outcome of the surgery?
  7. What is the long-term prognosis for patients who undergo pericardiectomy?
  8. How often will follow-up appointments be necessary after the procedure?
  9. What symptoms should I watch for that may indicate a complication or the need for medical attention post-surgery?
  10. Are there any lifestyle changes or restrictions I should be aware of following pericardiectomy?

Reference

Authors: Pajjuru VS, Warren BM, Daoud H, Radaideh Q, Walters RW, Alla VM. Journal: Am J Cardiol. 2023 Oct 15;205:298-301. doi: 10.1016/j.amjcard.2023.08.011. Epub 2023 Aug 24. PMID: 37633064