Patients with congenital heart disease (CHD) are surviving longer thanks to improved surgical techniques and increasing knowledge of natural history. Pleural effusions continue to be a complication that affect many surgical patients and are associated with increased morbidity, many times requiring readmission and additional invasive procedures. The risks for development of pleural effusion after hospital discharge are ill-defined, which leads to uncertainty related to strategies for prevention. Our primary objective was to determine, in patients with CHD requiring cardiopulmonary bypass, the prevalence of post-surgical pleural effusions leading to readmission. The secondary objective was to identify risk factors associated with post-surgical pleural effusions requiring readmission. We identified 4417 citations; 10 full-text articles were included in the final review. Of the included studies, eight focused on single-ventricle palliation, one looked at Tetralogy of Fallot patients, and another on pleural effusion in the setting of post-pericardiotomy syndrome. Using a random-effect model, the overall prevalence of pleural effusion requiring readmission was 10.2% (95% CI 4.6; 17.6). Heterogeneity was high (I2 = 91%). In a subpopulation of patients after single-ventricle palliation, the prevalence was 13.0% (95% CI 6.0;21.0), whereas it was 3.0% (95% CI 0.4;6.75) in patients mostly with biventricular physiology. We were unable to accurately assess risk factors. A better understanding of this complication with a focus on single-ventricle physiology will allow for improved risk stratification, family counseling, and earlier recognition of pleural effusion in this patient population.

中文翻译：

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先天性心脏手术后需要再次入院的胸腔积液：系统评价和荟萃分析。

先天性心脏病（CHD）患者的生存时间更长，这要归功于改良的手术技术和对自然史的了解。胸腔积液仍然是一种影响许多外科手术患者的并发症，并与发病率增加相关，很多时候需要再次入院和附加的侵入性手术。出院后出现胸腔积液的风险尚不明确，这导致与预防策略有关的不确定性。我们的主要目标是确定需要进行体外循环的冠心病患者中导致再次入院的手术后胸腔积液的患病率。次要目标是确定与需要再次入院的手术后胸腔积液相关的危险因素。我们确定了4417篇引文；最后的评论中包括10篇全文文章。在纳入的研究中，有八项研究侧重于单心室舒张，一项研究了法洛患者的四联症，另一项研究了心包切开术后综合征患者的胸腔积液。使用随机效应模型，需要再次入院的胸腔积液的总患病率为10.2％（95％CI 4.6； 17.6）。异质性很高（I2 = 91％）。在单心室缓解后的亚人群患者中，患病率为13.0％（95％CI 6.0; 21.0），而在大多数双心室生理患者中，患病率为3.0％（95％CI 0.4; 6.75）。我们无法准确评估风险因素。更好地了解这种并发症，并着重于单室生理学将有助于改善风险分层，家庭咨询，