In-Hospital Mortality Among Patients Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion with and Without Malignancy
Bibliographic record
Abstract
Background: Despite the high prevalence of malignant pericardial effusions (MPEs), the differences in mortality between those undergoing pericardiocentesis for MPE versus non-malignancy pericardial effusions (NMPEs) are not well characterized. To address this knowledge gap, we aim to compare clinical outcomes following pericardiocentesis among patients with MPE and NMPE. Methods: A retrospective analysis was conducted on the US National Inpatient Sample (NIS) to identify all hospitalizations during which pericardiocentesis was performed between 1 January 2016 and 31 December 2020 (total n = 174,776,205). This cohort was further stratified based on the presence or absence of malignancy. The primary outcome of interest was in-hospital mortality. Secondary outcomes included discharge disposition (categorized as non-home discharges), length of stay, and total hospitalization costs. Results: A total of 85,125 patients with pericardial effusions undergoing pericardiocentesis were identified. Patients with an MPE (n = 24,740) were younger and more likely to have a history of malnutrition, prior radiation, palliative care treatments, and do-not-resuscitate (DNR) orders compared to those with an NMPE (n = 60,385). Lung cancer was the most common malignancy (40.3%) in patients with an MPE requiring pericardiocentesis. The in-hospital mortality following pericardiocentesis was 11.8% in patients with malignancy and 8.2% in patients without (odds ratio (OR) for mortality 1.50 (95% confidence interval [CI]: 1.34–1.68, p < 0.001). Lung cancer, non-Hodgkin lymphoma, esophageal cancer, ovarian cancer, and leukemia were associated with a significantly increased risk of death during the same admission. Non-home discharge, length of stay, and total hospitalization cost were marginally greater in those with an MPE. Conclusions: In patients undergoing pericardiocentesis, those with an MPE had significantly higher in-hospital mortality compared to those with an NMPE. Additionally, the MPE group had a marginally longer length of stay and incurred higher total hospital costs. Further research is warranted to explore optimal treatment strategies for MPEs, particularly in patients with a limited life expectancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".