Abstract：
Background: Pericardial effusion (PCE) is a significant complication after pediatric cardiac surgery. This study investigates PCE development after the arterial switch operation (ASO) and its short-term and longitudinal impacts. Methods: A retrospective review of the Pediatric Health Information System database. Patients with dextro-transposition of the great arteries who underwent ASO from January 1, 2004, to March 31, 2022, were identified. Patients with and without PCE were analyzed with descriptive, univariate, and multivariable regression statistics. Results: There were 4896 patients identified with 300 (6.1%) diagnosed with PCE. Thirty-five (11.7%) with PCE underwent pericardiocentesis. There were no differences in background demographics or concomitant procedures between those who developed PCE and those who did not. Patients who developed PCE more frequently had acute renal failure (N = 56 (18.7%) vs N = 603(13.1%), P = .006), pleural effusions (N = 46 (15.3%) vs N = 441 (9.6%), P = .001), mechanical circulatory support (N = 26 (8.7%) vs N = 199 (4.3%), P < .001), and had longer postoperative length of stay (15 [11-24.5] vs 13 [IQR: 9-20] days). After adjustment for additional factors, pleural effusions (OR = 1.7 [95% CI: 1.2-2.4]), and mechanical circulatory support (OR = 1.81 [95% CI: 1.15-2.85]) conferred higher odds of PCE. There were 2298 total readmissions, of which 46 (2%) had PCE, with no difference in median readmission rate for patients diagnosed with PCE at index hospitalization (median 0 [IQR: 0-1] vs 0 [IQR: 0-0], P = .208). Conclusions: PCE occurred after 6.1% of ASO and was associated with pleural effusions and mechanical circulatory support. PCE is associated with morbidity and prolonged length of stay; however, there was no association with in-hospital mortality or readmissions.
摘要：
背景：心包积液（PCE）是小儿心脏手术后的重要并发症。这项研究调查了动脉转换手术（ASO）后PCE的发展及其短期和纵向影响。方法：对儿科健康信息系统数据库进行回顾性审查。从2004年1月1日至2022年3月31日进行ASO的大动脉右旋转位患者被确定。有和没有PCE的患者进行描述性分析，单变量，和多元回归统计。结果：4896例患者中300例（6.1%）被诊断为PCE。35例(11.7%)PCE患者接受了心包穿刺术。开发PCE的人和未开发PCE的人在背景人口统计学或伴随程序上没有差异。发生PCE更频繁的患者患有急性肾衰竭（N=56（18.7％）vsN=603（13.1％），P=.006)，胸腔积液（N=46（15.3％）vsN=441（9.6％），P=.001)，机械循环支持(N=26(8.7%)vsN=199(4.3%)，P<.001),术后住院时间更长(15[11-24.5]vs13[IQR:9-20]天)。在对其他因素进行调整后，胸腔积液（OR=1.7[95%CI：1.2-2.4]），和机械循环支持（OR=1.81[95％CI：1.15-2.85]）赋予PCE更高的几率。总共有2298次再入院，其中46人(2%)有PCE，在指数住院时诊断为PCE的患者的中位数再入院率没有差异（中位数0[IQR：0-1]vs0[IQR：0-0]，P=.208）。结论：PCE发生在6.1％的ASO后，并与胸腔积液和机械循环支持有关。PCE与发病率和住院时间有关；然而，与院内死亡率或再入院无关.
