ArticleGlobal cardiology science & practice2025
Etiological distribution and mortality factors in pericardial effusion: Insights from a large cohort study.
Article in Global cardiology science & practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPericardial effusion represents a potentially life-threatening clinical entity arising from diverse pathophysiological processes, with etiological prevalence demonstrating substantial geographic and ethnic variation. Despite this recognized heterogeneity, epidemiological data characterizing the distribution of pericardial effusion etiologies in Indian populations remain limited.
methodsThis observational cohort study enrolled 695 consecutive patients presenting with moderate-to-large pericardial effusion at a tertiary cardiac care center. Comprehensive demographic and etiological data were systematically collected, with prospective follow-up extending over a 24-month period.
resultsThe 695 patients exhibited a male predominance (55.68%). Etiological analysis revealed tuberculosis as the most frequent cause (32.52%), followed by malignancy (30.6%), idiopathic effusion (19.14%), hypothyroidism (7.77%), chronic kidney disease (5.75%), connective tissue disorders (3.16%), and pyogenic infections (1.0%). Among malignancy-associated effusions, pulmonary carcinoma accounted for 47.41% of cases. In patients presenting with cardiac tamponade, malignancy was identified in 47.12% and tuberculosis in 29.15%. Over the 24-month follow-up period, malignancy was responsible for 78.76% of observed mortality. Kaplan-Meier survival analysis demonstrated that patients with malignancy-associated effusion exhibited the poorest prognosis, followed sequentially by those with chronic kidney disease and tuberculosis.
conclusionTuberculous pericarditis emerged as the predominant etiology of pericardial effusion in this cohort. However, malignancy, particularly pulmonary carcinoma, constituted the principal cause of mortality, followed by chronic kidney disease and tuberculosis. Kaplan-Meier survival analysis underscored the adverse prognostic impact of malignancy-associated pericardial effusion, highlighting the critical importance of prompt diagnostic evaluation and therapeutic intervention.
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