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

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 29261792
OWN - NLM
STAT- In-Process
LR  - 20171220
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Prevalence and risk factors for postoperative stress-related cardiomyopathy in
      adults.
PG  - e0190065
LID - 10.1371/journal.pone.0190065 [doi]
AB  - 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.
FAU - Oh, Tak Kyu
AU  - Oh TK
AD  - Interdepartment of Critical Care Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Song, In-Ae
AU  - Song IA
AUID- ORCID: http://orcid.org/0000-0002-7814-4253
AD  - Interdepartment of Critical Care Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Park, Young-Mi
AU  - Park YM
AD  - Medical Research Collaborating Center, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Hwang, Jung-Won
AU  - Hwang JW
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Jeon, Young-Tae
AU  - Jeon YT
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Do, Sang-Hwan
AU  - Do SH
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Yoon, Yeonyee E
AU  - Yoon YE
AD  - Department of Cardiology, Cardiovascular Center, Seoul National University
      Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Ahn, Soyeon
AU  - Ahn S
AD  - Medical Research Collaborating Center, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
FAU - Lee, Jae-Sung
AU  - Lee JS
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University Bundang
      Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
LA  - eng
PT  - Journal Article
DEP - 20171220
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/12/21 06:00
MHDA- 2017/12/21 06:00
CRDT- 2017/12/21 06:00
PHST- 2017/09/14 00:00 [received]
PHST- 2017/12/07 00:00 [accepted]
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2017/12/21 06:00 [medline]
AID - 10.1371/journal.pone.0190065 [doi]
AID - PONE-D-17-33587 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 20;12(12):e0190065. doi: 10.1371/journal.pone.0190065.
      eCollection 2017.