Analysis of risk factors of multiorgan failure after pericardiectomy for constrictive pericarditis

• Published in: Journal of cardiothoracic surgery 2022-09, Vol.17 (1), p.1-244, Article 244
• Main Authors: Huang, Jing-bin, Wen, Zhao-ke, Yang, Jian-rong, Li, Jun-jun, Li, Min, Lu, Chang-chao, Liang, Da-ying, Wei, Cheng-xin
• Format: Article
• Language: English
• Subjects: Calcification; Cardiac arrhythmia; Cardiac catheterization; Cardiovascular disease; Creatinine; Extracorporeal membrane oxygenation; Fatalities; Fluid overload; Heart; Hospitals; Hydrochlorothiazide; Incomplete pericardial dissection; Intensive care; Intubation; Lactates; Lactic acid; Medical records; Medical research; Medicine, Experimental; Mortality; multiorgan failure; Oxygen saturation; Patients; Pericardiectomy; Pericarditis; Pericardium; Pulmonary arteries; Respiratory failure; Retention time; Risk analysis; Risk factors; Septicemia; Shock; Surgery; Tomography; Tuberculosis; Variables; Venous pressure; Ventricle; Ventricular fibrillation
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-022-02007-1

Background We aimed to investigate risk factors of multiorgan failure following pericardiectomy. Methods This was a retrospective study of patients undergoing pericardiectomy between January 1994 and May 2021 at three hospitals. Results 826 patients were included in the study and divided into two groups: group with multiorgan failure (n = 86) and group without multiorgan failure (n = 740). There were 86 patients with multiorgan failure (86/826, 10.4%). There were 66 operative deaths (66/826, 8.0%). The causes of operative deaths were multiorgan failure, including cardiogenic shock + AKI + ventricular fibrillation (13/66), cardiogenic shock + AKI (35/66), cardiogenic shock + AKI + hepatic failure + septicemia (8/66), cardiogenic shock + AKI + respiratory failure (10/66). Univariate and multivariate analyses showed the factors associated with multiorgan failure, including male (P = 0.006), time between symptoms and surgery (P < 0.001), thickness of pericardium (P < 0.001), intubation time (P < 0.001), ICU retention time (P < 0.001), hospitalized time postoperative (P < 0.001), preoperative central venous pressure (P < 0.001), postoperative central venous pressure (P < 0.001), D0 fluid balance (P < 0.001), D2 fluid balance (P < 0.001), postoperative chest drainage (P < 0.001), preoperative LVEDD(P < 0.001), postoperative LVEDD (P < 0.001), surgical duration (P < 0.001), bleeding during operation (P < 0.001), serum creatinine 24 h after surgery (P = 0.042), serum creatinine 48 h after surgery (P < 0.001), fresh-frozen plasma (P < 0.001), packed red cells (P < 0.001), blood lactate (P < 0.001). Conclusion In our study, incomplete pericardial dissection, fluid overload, delayed diagnosis and treatment are associated with multiorgan failure following pericardiectomy. Keywords: Incomplete pericardial dissection, Fluid overload, multiorgan failure, Pericardiectomy