Prevalence and risk factors for postoperative stress-related cardiomyopathy in adults

• Published in: PloS one Vol. 12; no. 12; p. e0190065
• Main Authors: Oh, Tak Kyu, Song, In-Ae, Park, Young-Mi, Hwang, Jung-Won, Jeon, Young-Tae, Do, Sang-Hwan, Yoon, Yeonyee E, Ahn, Soyeon, Lee, Jae-Sung
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20.12.2017; Public Library of Science (PLoS)
• Subjects: Adults; Analysis; Anesthesiology; Archives & records; Biology and Life Sciences; Body mass; Body mass index; Body size; Cardiology; Cardiomyopathy; Confidence intervals; Critical care; Health aspects; Heart; Hospitals; Hyponatremia; Incidence; Medical diagnosis; Medical records; Medical research; Medicine; Medicine and Health Sciences; Mortality; Myocardial diseases; Pain; Patients; Physical Sciences; Poisson density functions; Postoperative complications; Postoperative period; Prevalence studies (Epidemiology); Regression analysis; Research and Analysis Methods; Risk analysis; Risk factors; Sepsis; Social Sciences; Sodium; Statistical analysis; Stress; Stresses; Surgery; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0190065

Stress-related cardiomyopathy can develop during the postoperative period due to surgery-related stress factors. However, the prevalence and risk factors for this condition are not yet known. During a retrospective, observational study, patients older than 19 years who underwent procedures from January 2011 to December 2015 at a tertiary hospital were included. The main aim was to identify the prevalence and related risk factors for postoperative stress-related cardiomyopathy. To estimate the incidence per risk factor, univariate and multivariate Poisson regression analyses were performed. During the 5-year period, 95,840 patients older than 19 years underwent 125,314 procedures, and the prevalence of postoperative stress-related cardiomyopathy was 17.74 per 100,000 (95% confidence interval, 9.31-26.17), with an in-hospital mortality of 23.5%. As a result, three risk factors were significantly associated: preoperative American Society of Anesthesiologists classification (incidence rate ratio, 5.901 for American Society of Anesthesiologists class 1-2 [ref] versus 3-6; 95% confidence interval,1.289-27.002; P = 0.022); preoperative body mass index (incidence rate ratio, 1.247 for increases of 18.5 [ref] to 30; 95% confidence interval, 1.067-1.458; P = 0.006); and preoperative serum sodium (incidence rate ratio, 0.830 for each increase of 10 mmol/L from 130; 95% confidence interval, 0.731-0.942; P = 0.004). The incidence rate ratio for age for each increase of 10 years from 50 years was 1.057, but it was not statistically significant (P = 0.064). Our study found that the prevalence of postoperative stress-related cardiomyopathy was 17.74 patients per 100,000 adult patients over the course of 5 years, with four cases of in-hospital mortality. Factors that increased the risk of postoperative stress-related cardiomyopathy included higher American Society of Anesthesiologists class (≥3), preoperative hyponatremia, and higher preoperative body mass index.