Abstract
This study aimed to explore changes in the venous return system in patients with Constrictive pericarditis (CP) after pericardial stripping and examine their value in predicting mortality. An 8-year single-center retrospective cohort study including patients with CP after pericardial stripping surgery. Hemodynamic parameters were analyzed in 90 patients at 11 time points including before and after surgery and every 4 to 9 hours in the first 48 hours in the ICU (0h, t1-t3, 24h, t4-t6, 48h). Mean systemic filling pressure (Pmsf) and resistance to venous return (RVr) were significantly higher in patients who died (non-survival group) than survivors (P = 0.016 and 0.022, respectively). Pmsf at 0h, Pmsf at 24h, Pmsf − CVP at 0h, RVr before surgery, RVr at 24h, APACHE II score, and SOFA score were evaluated as predictors of 28-day mortality. The area under the receiver operating characteristic curve was largest for RVr before surgery (0.771; 95% confidence interval, 0.583–0.958; P = 0.034). SOFA combined with RVr before surgery had the best performance (area under the receiver operating characteristic curve, 0.883; 95% confidence interval, 0.758–1.000; P = 0.003). Pmsf, Pmsf − CVP, and RVr can be used as valid indicators for prognostic assessment in patients with constrictive pericarditis after pericardial stripping.