The frequency of cardiac complications with planned interventions
on the abdominal organs and large joints in the multi-profile hospitals in Moscow
Abstract
Modern guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery are mostly based on foreign works, and it is actual and important
to analyze cardiac risk in different kinds of non-cardiac surgery in Russia, taking in account
specificity of medical care in our country.
The aim of our study was to define frequency and severity of cardiac complications in concardiac surgery in several Moscow hospitals.
Methods. We have included 1112 patients, who underwent different planned non-cardiac surgical interventions. We have analyzed a data of patients' medical records. All cardiac complications (CC) were divided in two groups: major CC (cardiac death, myocardial infarction and
stroke) and minor CC (myocardial ischemia, severe ventricular arrhythmia, atrial fibrillation).
Results. 83 operations (7.5%) were of initial high cardiac risk (more than 5% risk of myocardial
infarction or cardiac death), other surgical interventions were of initial moderate risk (1–5%).
267 operations were performed in cancer patients (24.0%). Mean duration of hospitalization in
our study was 19 days (12–28 days), 90.8% patients left hospital in less than 26 days after operation. In 224 patients (20.1%) different CC were identified: major CC in 74 patients (6.6%);
minor CC in 150 patients (13.5%). There were recorded 57 cases of myocardial infarction:
39 – nonfatal, 18 – fatal; and 17 cases of stroke – 2 of them appeared to be fatal.
Conclusion. Results of our study indicate a high cardiac risk in planned non-cardiac surgical
interventions, mainly in cancer cases, that exceeds an initial risk, according to modern guidelines. Accurate perioperative care is certainly necessary in such patients.
Keywords:complication, surgery, cardiac risk, myocardium infarction, stroke, cardiac death
Clin. Experiment. Surg. Petrovsky J. 2017; 5 (2): 14–20.
DOI: 10.24411/2308-1198-2017-00028
Received: 25.10.2016. Accepted: 19.04.2017.
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