Risk factors for perioperative major cardiac events in Chinese elderly patients with coronary heart disease undergoing noncardiac surgery

Background Few studies have investigated perioperative major adverse cardiac events （MACEs） in elderly Chinese patients with coronary heart disease （CHD） undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncard...

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Bibliographic Details
Published in:Chinese medical journal 2013, Vol.126 (18), p.3464-3469
Main Authors: Liu, Zi-Jia, Yu, Chun-Hua, Xu, Li, Han, Wei, Jiang, Jing-Mei, Huang, Yu-Guang
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Coronary Disease - complications
Elective Surgical Procedures - adverse effects
Female
Humans
Logistic回归分析
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Assessment
事件
冠状动脉
危险因素
围手术期
心脏疾病
患者
老年
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Summary:Background Few studies have investigated perioperative major adverse cardiac events （MACEs） in elderly Chinese patients with coronary heart disease （CHD） undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncardiac surgery, and established a risk stratification system. Methods This retrospective observational clinical study included 482 patients aged -〉60 years with CHD who underwent elective major noncardiac surgery at the Peking Union Medical College Hospital. The primary outcome was MACE within 30 days after surgery. Risk factors were evaluated using multivariate Logistic regression analysis. Results Perioperative MACE occurred in 61（12.66%） of the study patients. Five independent risk factors for perioperative MACE were identified： history of heart failure, preoperative arrhythmia, preoperative diastolic blood pressure 〈75 mmHg, American Society of Anesthesiologists grade 3 or higher, and intraoperative blood transfusion. The area under the receiver operating characteristic curve for the risk-index score was 0.710＋0.037. Analysis of the risk stratification system showed that the incidence of perioperative MACE increased significantly with increasing levels of risk. Conclusions Elderly Chinese patients with CHD who undergo noncardiac surgery have a high risk of perioperative MACE. Five independent risk factors for perioperative MACE were identified. Our risk stratification system may be useful for assessing perioperative cardiac risk in elderly patients undergoing noncardiac surgery.
ISSN:0366-6999
2542-5641
DOI:10.3760/cma.j.issn.0366-6999.20122793