Analysis of Risk Factors of Multiorgan Failure After Pericardiectomy For Constrictive Pericarditis

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 (86/826, 10.4%), including cardiogenic shock + AKI + ventricular fibrillation (15/86), cardiogenic shock + AKI (46/86), cardiogenic shock + AKI + hepatic failure + septicemia (10/86), cardiogenic shock + AKI + respiratory failure (15/86). 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 24h after surgery (P=0.042), serum creatinine 48h 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.