Analysis Of Prognostic Factors Of Cardiac Surgery In Patient With Autoimmune Inflammatory Disease

Background and ObjectivesAutoimmune disease and Autoinflammatory disease were divided as two different types of diseases.But they are closely related and can be recognized as a kind of systemic disease,which is characterized by immune disorder and self-attacking inflammation,consisting of systemic lupus erythematosus,rheumatoid arthritis,Takayasu arthritis and Behcet disease etc.When cardiovascular system is affected and drugs are not capable of controlling the symptoms,surgery is required.However,surgery performed on patients with systemic disease is very challenging because the symptoms tend to have relapse after the operation.Previous study believes that pre-operational medical treatment and the method of operation can affect the outcome of a surgery,but number of cases are limited.Also there is rarely literature to explain the laboratory tests as predictors.The Objectives of this study are to summarize and analyze the clinical features,laboratory tests and information of the surgery in order to find out predictors of surgery on these autoimmune inflammatory diseases.MethodsWe searched our medical record system and obtained the patients'profiles and other materials,retrospectively summarize the clinical features,laboratory tests,echocardiogram and information of the operations.91 patients are included,and self-control will be used.A database is established using Excel,and the statistics analysis will be performed on SPSS using different method depending on the data type.Result1.In patients with autoimmune inflammatory disease,elevated level of hs-CRP increases the incidence of having a complication.(P=0.028,OR=1.023,95%CI 1.002-1.044).The time of cardiopulmonary bypass is also significantly related to having a complication.2.Infectious endocarditis significantly increases the mortality rate of patient with systemic diseases.(p=0.030)3.SLE patients with complications after operation have statistically significant lower level of hemoglobin.(p=0.020)4.Patients with higher level of hs-CRP tend to have post-operational complications.(P=0.048).5.Patients with Behcet disease have a significantly higher chance on second operation or death if not treated before.6.AVR as the first operation will lead to bad outcome.Conclusion1.For patients with autoimmune inflammatory diseases,higher level of hs-CRP and longer time of cardiopulmonary bypass will increase the risk of post-operational complications.2.Smaller age might lead to more severe disease and higher mortality rate.3.Infectious endocarditis significantly increases the mortality.4.Lower level of hemoglobin increases the incidence of complications on SLE patients.5.Higher level of hs-CRP increases the risk of having a complication of APS patients.6.Pre-operational diagnosis and early treatment will reduce the chance of having paravalvular leakage or death in Behcet disease.Aortic root replacement as the first operation can lower the risk of death and second operation.