Exploratory association of a composite preoperative myxoma-related clinical burden index with recovery duration after cardiac myxoma resection: a retrospective cohort study

Cardiac myxoma is a benign primary cardiac tumor, but its clinical impact varies with tumor size, mobility, valvular obstruction, pulmonary arterial pressure, and preoperative functional status. Whether an integrated myxoma-related preoperative clinical burden is associated with postoperative recovery remains unclear. We conducted a single-center retrospective cohort study of patients with preoperatively suspected and pathologically confirmed cardiac myxoma between 2020 and 2025. A seven-item composite myxoma-related clinical burden index was used as an exploratory descriptive measure. Index values of 0–2 and ≥ 3 were used for descriptive group comparisons. To reduce bias from undocumented components, the primary continuous association analysis used an index standardized to the number of evaluable components among patients with at least five of seven components available. Recovery outcomes were postoperative hospital stay and postoperative ICU stay. Associations were assessed using Spearman correlation and log-linear models, with the latter adjusted for age, sex, and albumin. The cohort included 79 patients, of whom 62 had index values of 0–2 and 17 had values ≥ 3. No clinically documented major postoperative event was identified during the index hospitalization. Median postoperative hospital stay was 14.5 (10, 18.75) days and 12 (10, 15) days in the two descriptive groups, respectively ( P = 0.243); median ICU stay was 3 (2, 4) days in both groups ( P = 0.963). In the primary standardized-index analysis, correlations with hospital stay (rho = − 0.178, P = 0.190; N = 56) and ICU stay (rho = 0.230, P = 0.086; N = 57) were not statistically significant. Adjusted geometric mean ratios per 1-point increase were 0.953 (95% CI, 0.896–1.014; P = 0.126) for hospital stay and 1.014 (95% CI, 0.951–1.082; P = 0.664) for ICU stay. Most sensitivity analyses were consistent with the primary findings, although an extreme-case analysis assigning all undocumented components a value of 1 showed a positive correlation with ICU stay. Older age was associated with longer postoperative hospital stay. In this exploratory cohort of patients undergoing isolated cardiac myxoma resection, no statistically significant association was detected between the composite preoperative myxoma-related clinical burden index and postoperative recovery duration. Created with BioRender (Agreement No. HA29PRL40Z)