Key result
Postoperative low cardiac output syndrome occurred in 15.3% of patients undergoing pericardiectomy and was associated with factors including fluid overload and tuberculosis pericarditis (P=0.026).
Why the study?
The study aimed to investigate risk factors for low cardiac output syndrome (LCOS) following pericardiectomy.
What are the risk factors associated with low cardiac output syndrome following pericardiectomy?
Cohort (n=826)
Yes
What are the risk factors associated with low cardiac output syndrome following pericardiectomy?
Incomplete pericardial dissection, fluid overload, delayed diagnosis, and tuberculosis pericarditis are significant risk factors for developing low cardiac output syndrome after pericardiectomy.
Merits caution with fluid management in pericardiectomy; leaves open prospective validation of risk factors.
BACKGROUND: We aimed to investigate risk factors of LCOS following pericardiectomy. METHODS: This was a retrospective study of patients undergoing pericardiectomy at three hospitals between January 1994 and May 2021. RESULTS: A total of 826 patients were divided into two groups: group with LCOS (N = 126) and group without LCOS (N = 700). The incidence of postoperative LCOS was 15.3%. There were 66 operative deaths (8.0%). Univariable and multivariable analyses showed that factors are associated with LCOS, including postoperative LVEDD (P < 0.001), preoperative LVEDD (P < 0.001), time between symptoms and surgery (P < 0.001), thickness of pericardium (P < 0.001), intubation time (P = 0.002), hospitalized time postoperative (P < 0.001), preoperative central venous pressure (P = 0.016), postoperative central venous pressure (P = 0.034), D0 fluid balance (P = 0.019), D2 fluid balance (P = 0.017), postoperative chest drainage (P < 0.001), surgical duration (P < 0.001), bleeding during operation (P = 0.001), serum creatinine 24h after surgery (P < 0.001), serum creatinine 48h after surgery (P = 0.017), fresh-frozen plasma (P = 0.005), packed red cells (P = 0.006), and tuberculosis pericarditis (P = 0.026). CONCLUSION: In our study, incomplete pericardial dissection, fluid overload, delayed diagnosis and treatment, and tuberculosis pericarditis are associated with LCOS following pericardiectomy.
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Huang et al. (2022) conducted a cohort in Low cardiac output syndrome following pericardiectomy (n=826). Risk factors (e.g., incomplete pericardial dissection, fluid overload, tuberculosis pericarditis) vs. Absence of risk factors was evaluated on Low cardiac output syndrome (LCOS). Postoperative low cardiac output syndrome occurred in 15.3% of patients undergoing pericardiectomy and was associated with factors including fluid overload and tuberculosis pericarditis (P=0.026).