Risk Factors of Postoperative Septic Cardiomyopathy in Perioperative Sepsis Patients

Abstract Objective: This study aimed to clarify the relevant risk factors of septic cardiomyopathy (SCM) in perioperative sepsis patients. Methods: This retrospective study evaluated patients who were diagnosed with sepsis during the perioperative period and postoperatively admitted to the ICU in the Second Affiliated Hospital of Soochow University, the First Affiliated Hospital of Soochow University, and the Suzhou Municipal Hospital between January 2017 and November 2020. They were divided into 2 groups as the septic cardiomyopathy group (SCM group) and non-septic cardiomyopathy group (NSCM group). Significant factors in the multivariate logistic regression analysis (i.e., P<0.1) were used to establish a model and screen risk factors for SCM. The area under the receiver operating characteristic curve was used to reflect the discriminative capability of the model. The Hosmer-Lemeshow goodness of fit test was used to evaluate the calibration capability of the model.Result: Among the 269 patients, 49 patients had SCM. Sequential Organ Failure Assessment (SOFA) score (adjusted odds ratio [AOR]=2.535, 95% confidence interval (CI): 1.186-1.821, P=0.000]) and endoscopic surgery (AOR=3.154, 95% CI: 1.173-8.477, P=0.023]) were identified to be independent risk factors for SCM. Patients with a SOFA score ≥7 had a 46.831-fold higher risk of SCM (AOR =46.831, 95% CI: 10.511-208.662, P<0.05). The model had good discriminative capability (area under the curve: 0.902 [95% CI: 0.852-0.953]) and calibration capability (c²=4.401, P=0.819). The predictive accuracy was 86.2%. The rates of mechanical ventilation and tracheotomy were significantly higher in the SCM group than in the NSCM group (all P<0.05). The SCM group also had significantly longer duration of mechanical ventilation (P<0.05) and significantly higher rates of continuous renal replacement therapy (CRRT) and CRRT-related mortality (P<0.05). Further, the total length of stay and hospitalization cost were significantly higher in the SCM group than in the NSCM group (P<0.05).Conclusion: Endoscopic surgery and SOFA score ≥7 during postoperative ICU admission are independent risk factors for SCM within 48 hours postoperatively in patients with perioperative sepsis.