背景:心包积液(PE)是一种罕见的儿童死亡的重要原因,因为在心包腔中收集了多余的液体。该研究旨在描述国家心脏转诊医院的PE概况,亚的斯亚贝巴,埃塞俄比亚。
方法:本研究采用横断面研究设计,对TikurAnbessa专科医院的儿童PE进行7年回顾。应用了描述性和分析性统计。
结果:研究期间有17,386例儿科急诊/急诊入院,体育占急诊室招生的0.47%。从71名纳入的科目中,59%(42)为男性,平均年龄为7.8±3.3岁。咳嗽或呼吸急促,73.2%(52)和发烧或呼吸急促,26.7%(19),是常见的症状。发病前的中位病程为14天(IQR:8-20)。心包积液的病因为感染性(培养阳性-23.9%,文化阴性-43.6%,结核性-4.2%),甲状腺功能减退(4.2%),炎症(12.7%),恶性肿瘤(7%)或继发于慢性肾脏疾病(1。4%)。金黄色葡萄球菌是血培养中最常见的分离细菌,12.7%(9),其余为假单胞菌,7%(5)和克雷伯菌,4.2%(3)。温和,中度和重度心包积液记录为22.5%(16),46.5%(33),31%(22)的研究对象,分别。据报道,50.7%(36)的受试者存在心包填塞。心包引流程序(心包穿刺术,开窗或心包切开术)对52.1%(37例)的PE病例进行了手术。PE的病死率为12.7%(9)。心包引流程序与死亡率呈负相关,调整后的赔率比0.11(0.01-0.99),p0.049)。
结论:PE占ER入院的0.47%。最常见的PE表现是持续约两周的呼吸道症状。葡萄球菌病因的化脓性心包炎是PE的最常见原因,病死率为12.7%。心包引流程序有助于降低死亡率。应评估所有PE病例的心包引流程序,以避免死亡。
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).
CONCLUSIONS: 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.