A Descriptive Case Series of Pericarditis Treatment After Trauma With Colchicine Monotherapy Versus Other Treatment

Limited data exist describing the optimal treatment of pericarditis after acute blunt or penetrating trauma. Treatment with high-dose nonsteroidal anti-inflammatory drugs (NSAID), colchicine, or corticosteroids may not be feasible due to concomitant injuries. This was a retrospective, single-center, descriptive case series at a large, academic, Level 1 Trauma Center over a 10-year period. Patients admitted to the trauma service with a diagnosis of pericarditis at any point during index admission were eligible for inclusion. Groups were defined as colchicine-based treatment (monotherapy or combination) and any therapy besides colchicine, including no medications (surgical). The primary endpoint was therapy escalation defined as treatment modification, chart note documenting therapy failure, rehospitalization, repeat pericardial surgical intervention, or documentation of recurrent pericarditis. Secondary outcomes were treatment intolerance documented in a chart note including gastrointestinal bleed (GIB) and acute kidney injury (AKI). Eleven patients with traumatic pericarditis were included. Four (36%) patients received colchicine-based therapy: monotherapy (2, [50%]) or combination with NSAID (2, [50%]). Seven (63%) patients received non-colchicine treatment: 2 (29%) NSAID alone; 5 (71%) surgical management without medication. There were no occurrences of therapy escalation in either group. Treatment intolerances occurred in 1 (25%; AKI) patient in the colchicine group and 3 (43%; AKI, 2 [29%], GIB, 1 [14%]) patients in the non-colchicine group. Pericarditis is a rare complication after trauma, and no patients in this case series demonstrated treatment escalation. Additional, larger sample studies are necessary to guide optimal treatment in this uncommon but important population.