Pericardial effusions in patients with cancer: Anesthetic management and survival outcomes Journal Article
| Authors: | Chai, C. M.; Seier, K.; Tan, K. S.; Chu, I.; Isbell, J. M.; Fischer, G. W.; Afonso, A. M. |
| Article Title: | Pericardial effusions in patients with cancer: Anesthetic management and survival outcomes |
| Abstract: | Objectives: The objective of this study was to describe practice patterns of anesthetic management during pericardial window creation. Design: Retrospective observational cohort study. Setting: Single tertiary cancer center. Participants: A total of 150 patients treated for cancer between 2011 and 2015 were included in the study. Measurements and Main Results: The primary objective was to evaluate anesthetic management in pericardial window creation. Secondary outcomes were 30-day mortality and overall survival after pericardial window creation. Thirty-day mortality was 19.3%, and median survival was 5.84 months. Higher American Society of Anesthesiologists (ASA) physical status of patients was associated with preinduction arterial line placement (51% ASA 3 v 79% ASA 4; p = 0.002) and use of etomidate for anesthetic induction (34% ASA 3 v 60% ASA 4; p = 0.003). However, there was no association between anesthetic management and presence of tamponade in these patients. Cardiac aspirate volume (per 10 mL: odds ratio [OR], 1.02 [95% CI, 1.0-1.04]; p = 0.026) and intraoperative arrhythmia (atrial fibrillation: OR, 6.76 [95% CI, 1.2-37.49]; p = 0.029; sinus tachycardia: OR, 4.59 [95% CI, 1.25-16.90]; p = 0.022) were associated independently with increased 30-day mortality. High initial heart rate (per 10 beats per minute: hazard ratio [HR], 1.18 [95% CI, 1.05-1.33]; p = 0.005) in the operating room and intraoperative sinus tachycardia (HR, 1.86 [95% CI, 1.15-3.03]; p = 0.012) were associated independently with worse overall survival. Conclusion: Risk of death after pericardial window creation remains high in patients with cancer. Variations in anesthetic management did not affect survival in oncologic patients with pericardial effusions. © 2020 Elsevier Inc. |
| Keywords: | survival; pericardial effusion; anesthetic management; cancer; subxiphoid pericardial window creation |
| Journal Title: | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume: | 35 |
| Issue: | 2 |
| ISSN: | 1053-0770 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-02-01 |
| Start Page: | 571 |
| End Page: | 577 |
| Language: | English |
| DOI: | 10.1053/j.jvca.2020.08.049 |
| PUBMED: | 32967792 |
| PROVIDER: | scopus |
| PMCID: | PMC8385658 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 January 2021 -- Source: Scopus |
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