Zhu Yuxiang, Jing Wenbin, Lv Pengfei, Zhu Yubao, Liu Zhigang
Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Tianjin, China.
Cardiovasc Diagn Ther. 2022 Feb;12(1):114-122. doi: 10.21037/cdt-21-400.
Postoperative arrhythmia (POA) is one of the common and serious postoperative complications. This retrospective study was conducted to investigate the clinical factors associated with POA and its short-term prognosis following mitral valve repair.
A total of 618 patients receiving mitral valve repair between January 2015 and November 2020 in our hospital were included in this retrospective study, including 318 males and 300 females and aged 53.9±9.3 years. The patients were grouped into arrhythmia and non-arrhythmia groups and investigated for risk factors associated with the prognosis of POA using multivariate logistic regression based on their clinical data.
POA was observed in 314 (50.8%) patients and atrial fibrillation (AF) was the most frequent (43.3%) type of POA. Compared with non-arrhythmia patients, arrhythmia patients had significantly longer time to use vasoactive drug use, longer intensive care unit (ICU) stay and longer hospital stay. In addition, the incidence of postoperative heart failure was significantly higher (P<0.05). Logistic regression analysis showed that preoperative arrhythmia [odds ratio (OR) =9.17; 95% confident interval (CI): 4.49-18.10], postoperative pain (OR =4.70; 95% CI: 1.55-6.12) and postoperative hypoxemia (OR =3.25; 95% CI: 1.04-6.28) were independently associated with POA.
This study demonstrates that the incidence of arrhythmia is relatively high after mitral valve repair and is associated with preoperative arrhythmia, postoperative pain and postoperative hypoxemia.
术后心律失常(POA)是常见且严重的术后并发症之一。本回顾性研究旨在探讨二尖瓣修复术后与POA相关的临床因素及其短期预后。
本回顾性研究纳入了2015年1月至2020年11月在我院接受二尖瓣修复的618例患者,其中男性318例,女性300例,年龄53.9±9.3岁。将患者分为心律失常组和非心律失常组,并根据其临床数据,采用多因素logistic回归分析POA预后的相关危险因素。
314例(50.8%)患者出现POA,其中房颤(AF)是最常见的POA类型(43.3%)。与非心律失常患者相比,心律失常患者使用血管活性药物的时间明显更长,重症监护病房(ICU)停留时间和住院时间更长。此外,术后心力衰竭的发生率明显更高(P<0.05)。logistic回归分析显示,术前心律失常[比值比(OR)=9.17;95%置信区间(CI):4.49-18.10]、术后疼痛(OR =4.70;95%CI:1.55-6.12)和术后低氧血症(OR =3.25;95%CI:1.04-6.28)与POA独立相关。
本研究表明,二尖瓣修复术后心律失常的发生率相对较高,且与术前心律失常、术后疼痛和术后低氧血症有关。