Risk factors for postoperative sepsis-induced cardiomyopathy in patients undergoing general thoracic surgery: a single center experience |
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Authors: | Yinghua Wang Xinming Zhai Minfang Zhu Yan Pan Min Yang Kaiyan Yu Ben He |
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Affiliation: | 1.Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China;2.Department of Intensive Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China;3.Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China |
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Abstract: | BackgroundThe current study aimed to investigate the incidence of sepsis-induced cardiomyopathy (SICM) in patients who received general thoracic surgery, along with the risk factors and management strategies for this complication.MethodsThe clinical records of 163 patients with postoperative sepsis were retrospectively reviewed. After propensity score matching, 144 patients were divided into 2 groups by stroke volume: the SICM group (n=72) and the non-SICM group (n=72).ResultsThe overall incidence of postoperative SICM was 53.99%. Multiple logistic regression analysis showed that stroke volume and C-reactive protein were independent predictors of mortality in patients with postoperative sepsis. Statistical analysis by t-test and χ2 test indicated that mortality (P=0.000), B-type natriuretic peptide (P=0.001), left ventricular ejection fraction (P=0.000), the mitral peak velocity of early filling/early diastolic mitral annular velocity (E/e’) (P=0.049), C-reactive protein (P=0.016), procalcitonin (P=0.013), serum creatinine (P=0.016), platelets (P=0.028), and lactic acid (P=0.002) were significantly associated with the occurrence of postoperative SICM. Among these parameters, B-type natriuretic peptide was identified as the best biomarker for predicting SICM by receiver operating characteristic (ROC) curve analysis.ConclusionsIt is vital to improve the diagnosis and standard management of SICM. A combined strategy comprising early detection of suspected infection, adequate use of antibiotics, close monitoring, effective drainage, and supportive care may improve the outcomes of patients with postoperative SICM. |
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Keywords: | Risk factor sepsis-induced cardiomyopathy (SICM) general thoracic surgery |
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