Health

The risk of major postoperative cardiac complications is higher than previously thought-ScienceDaily

According to a study published today, one in five high-risk patients undergoing major non-cardiac surgery develops one or more heart complications within a year. European Heart Journal-Acute Cardiovascular Care, Journal of the European Society of Cardiology (ESC).

“Our study reveals that we are more likely to die from heart problems and non-cardiac surgery than previously recognized,” said the author of the study, a Christian at the University of Basel, Switzerland.・ Dr. Pueracher said. “Patients are also at risk for a longer period of time than previously thought.”

This study was conducted in high-risk patients, including people aged 65-85 years and people aged 45-64 years with cardiovascular disease (coronary artery disease, peripheral arterial disease, or previous stroke). All patients had non-cardiac surgery and had to be hospitalized for at least one night. Types of procedures included internal organs, orthopedics, trauma, blood vessels, urinary cord, spinal cord, and chest surgery.

“People undergoing major surgery are getting older and suffering from other illnesses. These are the patients we focused on in our research,” said Dr. Puelacher. “By providing information on postoperative complications, our study provides an opportunity to make surgery even safer.”

More than 300 million surgeries are performed each year around the world. Despite the benefits, surgery can cause heart events, including heart attack, heart failure, cardiac rhythmic disorders, and death. Previous studies suggest that nearly three-quarters of patients who died after surgery had never been hospitalized for critical care and were not aware of the risks. In addition, some complications are not detected because they are asymptomatic. For example, a patient who has a heart attack shortly after surgery may not have chest pain because of painkillers. These asymptomatic heart attacks carry the same risk of death to a symptomatic patient.

This study included 2,265 patients. The average age was 73 years and 43% were female. Patients were followed up for one year after surgery for death from heart attack, heart failure, cardiac rhythmic disorders, and cardiovascular disease. All patients had continuous troponin measurements during hospitalization to detect asymptomatic heart attacks. This protein rises in the blood when the heart muscle is damaged.

Approximately 1 in 7 (15%) of patients had at least one cardiac complication within 30 days. The 30-day incidence of cardiac complications was highest in patients with thoracic surgery (22%), followed by vascular surgery (21%) and trauma surgery (19%). One in five patients (21%) had at least one cardiac complication within a year.

“This was one of the first studies to monitor patients for asymptomatic heart attacks after surgery,” said Dr. Puelacher. “These patients were at increased risk of subsequent events. At least one-third of patients who had an asymptomatic heart attack compared to just 10% of those who did not have an asymptomatic heart attack. He suffered from another heart complication. Studies show that measuring troponin levels before and two days after surgery may identify these patients and provide an opportunity to prevent further complications and death. There is. “

Most complications occurred within the first 30 days after surgery, especially within the first week. However, investigators have identified vulnerable periods of up to 5 months. Dr. Puelacher said: “Our results show that this high-risk patient group is more likely to have adverse cardiac events for 3-5 months after major surgery.”

Dr. Puelacher said the study did not investigate what patients could do to improve their outcomes. But he said, “Surgery is a process, not a quick solution. Don’t postpone surgery. However, if you have the time and want to get ready, stop smoking, move and eat healthy. Please be in good physical condition. “

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material Provided by European Society of Cardiology.. Note: The content can be edited in style and length.

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