PMID- 34722042
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240403
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 9
DP  - 2021 Sep
TI  - Pericardiectomy for Constrictive Tuberculous Pericarditis: A Systematic Review 
      and Meta-analysis on the Etiology, Patients' Characteristics, and the Outcomes.
PG  - e18252
LID - 10.7759/cureus.18252 [doi]
LID - e18252
AB  - Tuberculosis (TB) is the most common etiology of constrictive pericarditis in the 
      developing world. In this study, we collected currently available data to 
      evaluate the outcomes following pericardiectomy in patients with constrictive 
      tuberculous pericarditis. We retrieved electrical databases, including PubMed and 
      PubMed Central, from 1985 AD and onwards. We included articles that had more than 
      80% TB as the etiology and articles with mixed etiologies. Pooled analysis was 
      done in Review Manager (RevMan) version 5.2 (The Nordic Cochrane Centre, 
      Copenhagen). and Stata Statistical Software, Release 16 ( StataCorp LLC, College 
      Station, TX). We compared the mortality in patients after pericardiectomy due to 
      TB with other etiologies. In-hospital mortality versus one-year mortality was 
      analyzed in studies with constrictive pericarditis of mixed etiologies. We also 
      compared pre-operative New York Heart Association (NYHA) grade to post-operative 
      NYHA grade one year after pericardiectomy. We calculated the pooled mean of 
      postoperative hospital stay, postoperative intensive care unit (ICU) stay, and 
      in-hospital mortality. A total of 12 articles and 859 patients were included in 
      the final analysis. Pericardiectomy was performed mostly on middle-aged men with 
      or without previous comorbidity. Total pericardiectomy was the preferred surgical 
      procedure performed on a mean of 93% of patients. The pooled analysis shows a 
      significant decrease in all-cause mortality in patients with TB as compared to 
      other etiologies (pooled risk ratios (RR) 0.34 CI [0.12,1.01] I2 = 61%) and a 
      lower but insignificant in-hospital mortality in comparison to one-year mortality 
      in studies with mixed etiologies (RR 0.59 [0.11,3.11] I2= 61%). There was a 
      significant improvement in the NYHA grade of the patients one year following 
      pericardiectomy (RR 8.04, CI [5.20,12.45], I2= 0%). The mean postoperative 
      hospital stay and the postoperative ICU stay were calculated and reported in 
      terms of days. The mean postoperative hospital stays in studies with more than 
      80% of TB cases is 13.34 (10.21, 16.47) with a mean standard deviation of 4.46 
      (2.87, 6.05). The mean postoperative ICU stay is 1.93 (1.47, 2.39), with a mean 
      standard deviation of 3.26 (2.51, 4.00), and the mean in-hospital mortality is 
      0.07 (0.02, 0.12). Similarly, the mean postoperative hospital stay in studies 
      with mixed etiologies is 19.40 (11.93, 26.87) with a mean standard deviation of 
      8.26 (4.21, 12.52). The mean postoperative ICU stay is 3.52 (1.93, 5.10) with a 
      mean standard deviation of 2.34 (1.36, 3.32). The mean in-hospital mortality is 
      0.06 (0.04, 0.08). There is significant heterogeneity along with a number of 
      methodological concerns, and therefore, generalization of the data should be done 
      with caution, and a randomized controlled trial in the future may be beneficial.
CI  - Copyright (c) 2021, Yadav et al.
FAU - Yadav, Shikha
AU  - Yadav S
AD  - Medicine, Kathmandu University, Kathmandu, NPL.
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Shah, Suchitra
AU  - Shah S
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Iqbal, Zafar
AU  - Iqbal Z
AD  - Emergency Medicine, California Institute of Behavioral Neurosciences & 
      Psychology, Fairfield, USA.
AD  - Emergency Department, The Kidney Center, Karachi, PAK.
FAU - Alharbi, Mohammed G
AU  - Alharbi MG
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
AD  - Internal Medicine, Northern Border University, Arar, SAU.
AD  - Internal Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 
      SAU.
FAU - Kalra, Harjeevan S
AU  - Kalra HS
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Suri, Megha
AU  - Suri M
AD  - Medicine-Pediatrics, California Institute of Behavioral Neurosciences & 
      Psychology, Fairfield, USA.
FAU - Soni, Nitin
AU  - Soni N
AD  - Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Okpaleke, Nkiruka
AU  - Okpaleke N
AD  - Psychiatry and Behavioral Sciences, California Institute of Behavioral 
      Neurosciences & Psychology, Fairfield, USA.
FAU - Hamid, Pousette
AU  - Hamid P
AD  - Neurology, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210924
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8544905
OTO - NOTNLM
OT  - constrictive pericarditis
OT  - constrictive tuberculous pericarditis
OT  - pericardiectomy
OT  - pericarditis
OT  - tuberculosis
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/11/02 06:00
MHDA- 2021/11/02 06:01
PMCR- 2021/09/24
CRDT- 2021/11/01 09:21
PHST- 2021/08/18 00:00 [received]
PHST- 2021/09/24 00:00 [accepted]
PHST- 2021/11/01 09:21 [entrez]
PHST- 2021/11/02 06:00 [pubmed]
PHST- 2021/11/02 06:01 [medline]
PHST- 2021/09/24 00:00 [pmc-release]
AID - 10.7759/cureus.18252 [doi]
PST - epublish
SO  - Cureus. 2021 Sep 24;13(9):e18252. doi: 10.7759/cureus.18252. eCollection 2021 
      Sep.