Preoperative biomarkers as early warnings: a new perspective on assessing the risk of adverse outcomes in constrictive pericarditis surgery

Pericardiectomy is the only effective and reliable treatment for constrictive pericarditis. However, the incidence of postoperative complications and in-hospital mortality remains relatively high. Identifying the risk factors for major adverse outcomes is of great significance to predict results and reduce postoperative complications. From January 2022 to January 2024, patients who underwent pericardiectomy at the Third People’s Hospital of Chengdu were included in this study. Based on clinical outcomes, the patients were divided into the group without major adverse outcomes and the group with major adverse outcomes. Univariate and multivariate analysis were performed to compare the clinical characteristics of the two groups before and after surgery. A total of 75 tuberculosis constrictive pericarditis patients were included in this study. Univariate analysis found the level of albumin (64.41 ± 7.66) vs. (61.26 ± 9.99) is significantly lower (p = 0.016) in the group with major adverse outcomes. And the percentage of monocyte [(7.39 ± 2.09) vs. (8.86 ± 3.00)] and hemoglobin [(126.79 ± 18.72) vs. (134.74 ± 16.91) ]are significantly higher (p = 0.015, p = 0.036) in the group with major adverse outcomes. Multivariate Logistic regression analysis showed that lower albumin (OR = 0.873, 95% CI: 0.771–0.962, p = 0.013), higher monocyte percentage (OR = 1.252, 95% CI: 1.013–1.563, p = 0.045), and higher hemoglobin (OR = 1.044, 95% CI: 1.002–1.071, P = 0.044) were independent risk factors for postoperative adverse outcomes. For patients with tuberculosis constrictive pericarditis, lower levels of preoperative albumin, and higher hemoglobin and higher monocyte percentage were significantly associated with an increased risk of adverse outcomes after pericardiectomy. This study emphasizes the importance of preoperative assessment of these clinical parameters, which is helpful for early identification of high-risk patients, optimization of treatment strategies, and improvement of postoperative recovery and long-term prognosis.