■凝血指标对缩窄性心包炎患者行心包切除术后结局的影响研究甚少。本研究旨在评估术前凝血指标在这些患者中的预后作用。
■我们回顾性纳入158例缩窄性心包炎患者行心包切除术。采用ROC曲线评价凝血指标对术后并发症的诊断价值。根据ROC曲线计算的截止值将患者分为两组。比较两组患者术后疗效。采用Logistic回归分析确定术后并发症的危险因素。
■ROC曲线显示,在不同的凝血指标中,术前D-二聚体(DD)水平可有效鉴别患者术后并发症(AUC0.771,95%CI0.696~0.847,P<0.001)。患者分为低DD组和高DD组。术后结果的比较表明,术前DD水平高与使用血管活性剂的持续时间长显著相关(P=0.018)。插管(P=0.020),ICU住院时间(P=0.008),胸腔引流(P=0.004)和住院时间(P=0.002)。多因素分析显示术前高DD水平是术后并发症的独立危险因素(OR6.892,95%CI2.604~18.235,P<0.001)。
■术前高DD水平与术后不良结局显著相关,可以为缩窄性心包炎患者的术后并发症提供有效的预测能力。
UNASSIGNED: The impact of coagulation indicators on postoperative outcomes of patients with constrictive pericarditis undergoing pericardiectomy has been poorly investigated. This study aimed to assess the prognostic role of preoperative coagulation indicators in these patients.
UNASSIGNED: We retrospectively included 158 patients with constrictive pericarditis undergoing pericardiectomy. The diagnostic values of coagulation indicators for postoperative complications were evaluated by ROC curves. Patients were divided into two groups according to the cutoff value calculated by ROC curve. Postoperative outcomes were compared between the two groups. Logistic regression analysis was performed to identify risk factors of postoperative complications.
UNASSIGNED: ROC curve showed that among different coagulation indicators, preoperative D-dimer (DD) level could effectively identify patients with postoperative complications (AUC 0.771, 95% CI 0.696-0.847, P < 0.001). Patients were divided into the low DD group and the high DD group. The comparison of postoperative outcomes suggested that high preoperative DD level was significantly associated with longer durations of vasoactive agents using (P = 0.018), intubation (P = 0.020), ICU stay (P = 0.008), chest drainage (P=0.004) and hospital stay (P = 0.002). Multivariable analysis showed that high preoperative DD level was the independent risk factor of postoperative complications (OR 6.892, 95% CI 2.604-18.235, P < 0.001).
UNASSIGNED: High preoperative DD level was significantly linked to poor postoperative outcomes and could provide an effective prediction ability for postoperative complications in patients with constrictive pericarditis.