Background: Postpericardiotomy syndrome (PPS) is a common
complication after cardiac surgery. However, large-scale
epidemiological studies concerning the effect of procedure type on the
occurrence of PPS and mortality of PPS patients have not yet been
performed.

Methods: We studied the association of PPS
occurrence with operation type and post-operative mortality in a
nationwide follow-up analysis of 28761 consecutive patients entering
CABG, aortic valve replacement (AVR), mitral valve replacement (MVR) or
ascending aortic procedure. Only PPS episodes severe enough to result in
hospital admission (99.4% of included PPS cases) or to contribute as a
cause of death (0.6%) were included. Data were collected from mandatory
Finnish national registries including data on all cardiovascular
hospital admissions in 29 hospitals and causes of death between 2005 and
2014.

Results: Of all the patients included, 493 developed
PPS during the study period. The occurrence of PPS was significantly
higher in AVR (HR 1.97, 95% CI 1.58–2.46, p<0.0001), MVR (HR 1.62,
95% CI 1.22–2.15, p=0.0009) and aortic procedure (HR 3.06, 95% CI
2.24–4.16, p<0.0001), when compared to CABG procedure in both
univariable and multivariable analyses. Urgent or emergency procedure
was an independent predictor of PPS (HR 1.36, 95% CI 1.00–1.83,
p=0.047). Occurrence of PPS decreased significantly with aging
(p<0.0001). Occurrence of PPS was associated with an increased risk
of mortality within the first year after the surgery (adjusted HR 1.78,
95% CI 1.12–2.81, p=0.014).

Conclusions: The occurrence of
PPS was higher after AVR, MVR and aortic surgery when compared to CABG
procedure. Aging decreased the risk of PPS. Development of PPS was
associated with higher mortality within the first year after cardiac or
ascending aortic surgery.