Department of Anesthesiology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Area B24, Yinquan Road, Xincheng District, Qingyuan City, Guangdong Province, People's Republic of China.
BMC Cardiovasc Disord. 2023 Oct 4;23(1):485. doi: 10.1186/s12872-023-03535-x.
Electrocardiographic markers, as surrogates for sympathetic excitotoxicity, are widely predictive of cardiovascular adverse events, but whether these markers can predict postsurgical sepsis (SS) is unclear.
We retrospectively analyzed patients who underwent abdominal surgery from March 2013 to May 2023. We collected basic data, comorbidities, blood samples, echocardiology, electrocardiogram, and surgical data, as well as short-term outcome. The primary endpoints were postsurgical SS, in which logistic regression analyses can identify independent risk factors. The optimal cut-off value predictive postsurgical SS both P wave and PR interval were calculated in the receiver operating characteristic curve (ROC).
A total of 1988 subjects were analyzed, and the incidence of postsurgical SS was 3.8%. The mean age at enrollment was 68.6 ± 7.1 years, and 53.2% of the participants were men. In the ROC analysis, the areas under the curve (AUC) for P wave and PR interval predictive postsurgical SS were 0.615 (95%CI, 0.548-0.683; p = 0.001) and 0.618 (95%CI, 0.554-0.682; p = 0.001), respectively. The P wave and PR interval predicted postoperative sepsis with optimal discrimination of 103 and 157 ms, with a sensitivity of 0.744 and 0.419, and a specificity of 0.427 and 0.760. P-wave less than 103 ms or PR interval less than 157 ms associated with a 2.06 or 2.33 fold increase occurred risk postsurgical SS.
Shorter P-wave and PR intervals were both independently associated with postsurgical SS. These preoperative electrophysiological markers could have potential useful for early recognition of postoperative SS.
心电图标志物作为交感神经兴奋毒性的替代物，广泛预测心血管不良事件，但这些标志物是否可以预测手术后脓毒症（SS）尚不清楚。
我们回顾性分析了 2013 年 3 月至 2023 年 5 月接受腹部手术的患者。我们收集了基本数据、合并症、血液样本、超声心动图、心电图和手术数据以及短期结果。主要终点是手术后 SS，其中逻辑回归分析可以确定独立的危险因素。通过接受者操作特征曲线（ROC）计算预测手术后 SS 的最佳截断值 P 波和 PR 间期。
共分析了 1988 例患者，手术后 SS 的发生率为 3.8%。入组时的平均年龄为 68.6±7.1 岁，53.2%的参与者为男性。在 ROC 分析中，P 波和 PR 间期预测手术后 SS 的曲线下面积（AUC）分别为 0.615（95%CI，0.548-0.683；p=0.001）和 0.618（95%CI，0.554-0.682；p=0.001）。P 波和 PR 间期分别以 103 和 157 ms 的最佳截距预测术后脓毒症，敏感性分别为 0.744 和 0.419，特异性分别为 0.427 和 0.760。P 波小于 103 ms 或 PR 间期小于 157 ms 与手术后 SS 的风险增加 2.06 或 2.33 倍相关。
较短的 P 波和 PR 间期均与手术后 SS 独立相关。这些术前电生理标志物可能对早期识别术后 SS 具有潜在的有益作用。
