Background: There is a paucity of data about the risk factors affecting the survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion submitted to surgical intervention.
Methods: Between 2004 and 2011, we retrospectively analyzed 153 patients who underwent subxiphoid pericardial window as their surgical intervention in our center. In order to determine the effect of risk factors on survival rate, demographic data, clinical records, echocardiographic, computed tomographic and cytopathological findings and also operative information of patients was recorded. Patients were followed until the last clinical follow up (annually, last follow up was August 2012) or death. To determine prognostic factors affecting survival, univariate analyses as well as multivariate Cox regression were utilized.
Results: There were 89 men and 64 women with a mean age of 50.3 ± 15.5 years. The most prevalent symptom was dyspnea. Concurrent malignancies were present in 66 patients. The most prevalent primary site for malignancy showed to be lung. The median follow up was 15 months (range, 1-85 months). Six-month, one-year and 18- month survival rates were 85.6%, 61.4 % and 36.6% respectively. In multivariate analysis a positive history of lung cancer (hazard ratio [HR] 2.894, 95% confidence interval [CI] 1.362- 6.147, p=0.006) or other organ cancer (HR 2.315, 95% CI 1.009- 50311, p=0.048); presence of mass in the computed tomography (HR 1.985, 95% CI 1.100- 3.581, p=0.023); and echocardiographic findings compatible with tamponade (HR 1.745, 95% CI 1.048- 2.90 p=0.032) were the three independent predictors of post operation death.
Conclusions: Patients with underlying malignant disease especially with lung cancer or a detectable invasion of thorax in computed tomography or echocardiographic findings compatible with tamponade have a poor survival. Therefore, minimally invasive therapies could be considered as an acceptable alternative for these high-risk patients.