PREDICTORS OF CLINICAL OUTCOME DURING HOSPITALIZATION IN POST PERICARDIOCENTESIS AT SANGLAH GENERAL HOSPITAL

Pericardiocentesis is a life-saving action especially in cases of cardiac tamponade with severe hemodynamic disorders if done immediately. Current European Cardiology Society guidelines provide class I recommendations for pericardiocentesis in cases of cardiac tamponade or moderate to large pericardial effusion that are unresponsive to medical therapy and suspected bacterial etiology or malignancy. Pericardiocentesis is recommended by experienced operators under fluoroscopic or echocardiographic guidelines to reduce the risk of complications (Adler, Charron et al. 2015).
Post pericardiocentesis complications can affect a patient's clinical outcomes. Transient left ventricular dysfunction after pericardiocentesis is a rare complication with the incidence rate still unknown. This complication can occur several hours to several days after the procedure marked by pulmonary edema to cardiogenic shock in severe cases. Ventricular function usually returns to normal gradually in 7 to 10 days with complete recovery and good clinical outcomes when treated appropriately (Gluer, Murdoch et al. 2015).
The number of pericardiocentesis (volume of procedures) that have been done in a hospital is inversely proportional to the mortality rate. The more cases of pericardiocentesis that have been done, the lower the mortality rate and vice versa. In addition, older age, hemodynamic instability, respiratory failure, and the need for mechanical ventilation are associated with higher mortality after pericardiocentesis. Asians, residents of Pacific islands or races other than Hispanic or Black have significantly higher mortality rates compared to whites. This may represent racial differences rather than accidental findings, and needs to be explored further in the future. Meanwhile, pericardial disease, thyroid abnormalities, pleurisy / pleural effusion and congestive heart failure are associated with lower mortality. This underlines the effect of comorbidity on the clinical outcomes of patients after pericardiocentesis (Hinton and Wilkinson 2018, Gad, Elgendy et al. 2019).

Although it is a common procedure, there are no studies that assess clinical outcomes of patients post national or local pericardiocentesis. 
Therefore, this study aims to identify predictive factors for clinical outcomes during hospitalization in patients post pericardiocentesis at Sanglah Hospital Denpasar.