Key result
Pericardial drainage procedures were associated with a significant reduction in mortality among children with pericardial effusion (adjusted OR 0.11).
Why the study?
Pericardial effusion is a rare yet important cause of child mortality, prompting a study to describe its profile at a national cardiac referral hospital in Addis Ababa, Ethiopia.
Does pericardial drainage procedure reduce mortality in children with pericardial effusion?
Cross-Sectional (n=71)
No
Does pericardial drainage procedure reduce mortality in children with pericardial effusion?
In a pediatric cohort in Ethiopia, purulent pericarditis was the most common cause of pericardial effusion, and pericardial drainage procedures were associated with a significant reduction in mortality.
BACKGROUND: Pericardial effusion (PE) is a rare yet an important cause of child mortality due to collection of excess fluid in pericardial space. The study aimed to describe the PE profile in the national cardiac referral hospital, Addis Ababa, Ethiopia. METHODS: The study employed cross-sectional study design for a 7-year review of childhood PE in Tikur Anbessa Specialized Hospital. Descriptive and analytic statistics were applied. RESULTS: There were 17,386 pediatric emergency/ER admissions during the study period, and PE contributed to 0.47% of ER admissions. From 71 included subjects, 59% (42) were males with mean age of 7.8 ± 3.3 years. Cough or shortness of breath,73.2% (52) and fever or fast breathing, 26.7% (19), were the common presenting symptoms. The median duration of an illness before presentation was 14days (IQR: 8-20). The etiologies for pericardial effusion were infective (culture positive-23.9%, culture negative-43.6%, tuberculous-4.2%), hypothyroidism (4.2%), inflammatory (12.7%), malignancy (7%) or secondary to chronic kidney disease (1. 4%). Staphylococcus aureus was the most common isolated bacteria on blood culture, 12.7% (9) while the rest were pseudomonas, 7% (5) and klebsiella, 4.2% (3). Mild, moderate and severe pericardial effusion was documented in 22.5% (16), 46.5% (33), and 31% (22) of study subjects, respectively. Pericardial tamponade was reported in 50.7% (36) of subjects. Pericardial drainage procedure (pericardiocentesis, window or pericardiotomy) was performed for 52.1% (37) PE cases. The case fatality of PE was 12.7% (9). Pericardial drainage procedure was inversely related to mortality, adjusted odds ratio 0.11(0.01-0.99), p 0.049). CONCLUSION: PE contributed to 0.47% of ER admissions. The commonest PE presentation was respiratory symptoms of around two weeks duration. Purulent pericarditis of staphylococcal etiology was the commonest cause of PE and the case fatality rate was 12.7%. Pericardial drainage procedures contributed to reduction in mortality. All PE cases should be assessed for pericardial drainage procedure to avoid mortality.
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Amare et al. (2024) conducted a cross-sectional in Pericardial effusion (n=71). Pericardial drainage procedure vs. No pericardial drainage procedure was evaluated on Mortality (hospital discharge outcome) (adjusted OR 0.11, 95% CI 0.01-0.99, p=0.049). Pericardial drainage procedures were associated with a significant reduction in mortality among children with pericardial effusion (adjusted OR 0.11).
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