In-hospital mortality after pericardiocentesis: role of effusion etiology and hemodynamic physiology.

AIMS: This study evaluated the impact of effusion etiology, hemodynamic presentation, and comorbidity burden on in-hospital outcomes following pericardiocentesis.

PATIENTS AND

METHODS

A retrospective analysis of 62 adults who underwent pericardiocentesis at a tertiary academic hospital (2021-2024) was performed. The primary outcome was in-hospital mortality. The Charlson Comorbidity Index (CCI) and a post hoc Pericardial Risk Score (PRS) were evaluated as predictors.

RESULTS

Median age was 72 years (55% male; median CCI 2). Complications occurred in 13% and recurrence in 10%. In-hospital mortality was 8.1% (5/62), limited to malignant, ischemic, infectious, or anticoagulation-related effusions. The PRS showed a stepwise increase in mortality from 0% (PRS 0) to 25% (PRS 2) (p = 0.037), while the CCI did not predict mortality (p = 0.27).

CONCLUSIONS

Pericardiocentesis remains safe and effective with low recurrence. Mortality is driven by effusion etiology and hemodynamic severity rather than comorbidity burden. A simple etiology-physiology risk score outperformed the CCI and may help guide post-procedural management.