Key result
Elevated neutrophil-to-lymphocyte ratio modestly predicts mortality after pericardiocentesis for moderate-to-large pericardial effusion.
Why the study?
Pericardial effusion is relatively common in daily clinical practice, but no study had evaluated laboratory parameters that predict mortality in these patients.
Cohort (n=156)
No
Effect estimate: AUC 0.622 (95% CI 0.541-0.698)
p-value: p=0.013
In patients undergoing pericardiocentesis for moderate-to-large pericardial effusions, increasing age, malignant etiology, hypoalbuminemia, and elevated neutrophil/lymphocyte ratio are significant prognostic factors for mortality.
NLR >4.49 may support mortality risk stratification after pericardiocentesis; hypothesis-generating and requires prospective validation before clinical use.
Aim Pericardial effusion is relatively common in daily clinical practice. To our knowledge, no study to date has been conducted on any laboratory parameter that predicts mortality in patients presenting with pericardial effusion. The present study evaluated the prognostic factors of patients with moderate to large pericardial effusions requiring pericardiocentesis.Material and methods This retrospective study included 156 patients who underwent pericardiocentesis in our hospital between 2013 and 2022.Results 73 of the patients (46.8 %) survived. Nonsurvivors had hypoalbuminemia more often than survivors (p<0.001). Median follow-up time in non-survivors was 274.5 [4.0-3507.0] days, while median follow-up time in survivors was 1490.0 [109.0-3209.0]. In-hospital mortality was seen in only 8 patients. The median neutrophil / lymphocyte ratio was significantly lower in survivors than nonsurvivors (p=0.005). The ROC curve analysis showed that the neutrophil / lymphocyte ratio was higher than 4.49, with sensitivity and specificity rates of 78.57 % and 51.75 % in predicting mortality (AUC=0.622, 95 % confidence interval: 0.541-0.698, p=0.013).Conclusions The present study showed that the neutrophil / lymphocyte ratio and hypoalbuminemia, which are laboratory values at the time of admission, albumin in the pericardial fluid, and malignant pathology all play roles in the prognosis of pericardial effusion requiring pericardiocentesis.
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Gülaştı et al. (2025) conducted a cohort in Moderate-to-large pericardial effusion requiring pericardiocentesis (n=156). Neutrophil/lymphocyte ratio > 4.49 vs. Neutrophil/lymphocyte ratio ≤ 4.49 was evaluated on All-cause mortality (AUC 0.622, 95% CI 0.541-0.698, p=0.013). An admission neutrophil/lymphocyte ratio higher than 4.49 predicted mortality with an AUC of 0.622 in patients with moderate-to-large pericardial effusion requiring pericardiocentesis.
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