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

Jing-Bin Huang1, Zhao-Ke Wen2, Jian-Rong Yang2

  • 1Department of Cardiothoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, and Guangxi Academy of Medical Sciences, 6 Taoyuan Road, Nanning, 530021, Guangxi, China. hjb010222@163.com.

Journal of Cardiothoracic Surgery
|September 30, 2022
PubMed

Insights

Multiorgan failure after pericardiectomy is linked to factors like incomplete dissection and fluid overload. Early diagnosis and treatment are crucial for better outcomes in patients undergoing this procedure.

Area of Science:

  • Cardiothoracic Surgery
  • Critical Care Medicine
  • Nephrology

Background:

  • Pericardiectomy is a surgical procedure to remove part or all of the pericardium.
  • Multiorgan failure (MOF) is a significant complication following major surgeries, including pericardiectomy.
  • Identifying risk factors for MOF post-pericardiectomy is essential for improving patient outcomes.

Purpose of the Study:

  • To investigate the risk factors associated with multiorgan failure (MOF) after pericardiectomy.
  • To identify specific clinical and intraoperative variables that predict MOF development.

Main Methods:

  • A retrospective study was conducted involving 826 patients who underwent pericardiectomy between January 1994 and May 2021 across three hospitals.
  • Patients were categorized into two groups: those who developed MOF (n=86) and those who did not (n=740).
  • Statistical analyses, including univariate and multivariate analyses, were performed to identify associated factors.

Main Results:

  • 10.4% of patients (86/826) experienced multiorgan failure post-pericardiectomy.
  • Operative mortality was 8.0% (66/826), with MOF being a primary cause.
  • Significant risk factors identified included male sex, prolonged time from symptom onset to surgery, pericardial thickness, extended intubation and ICU stay, high postoperative fluid balance, elevated central venous pressure, increased LVEDD, longer surgical duration, intraoperative bleeding, and elevated postoperative creatinine and lactate levels.

Conclusions:

  • Incomplete pericardial dissection, fluid overload, and delayed diagnosis/treatment are associated with multiorgan failure following pericardiectomy.
  • These findings highlight the importance of meticulous surgical technique and proactive management of fluid balance and diagnostic timelines.
Abstract

Keywords:
Fluid overloadIncomplete pericardial dissectionPericardiectomymultiorgan failure

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