Accompanying Cardiac Issues and Their Effects on Morbidity and Mortality In Patients Undergoing Noncardiac Surgery

Öz

Objective: This study aimed to determine the frequency of perioperative cardiac problems and their effects on perioperative cardiac morbidity and mortality in patients undergoing non-cardiac surgery. Material and Method: Patients who were followed up postoperatively in clinics after non-cardiac surgery were evaluated, and 3003 patients were analyzed. Preoperative demographic and clinical characteristics were recorded. In the postoperative period, hypotension, bradycardia, or hemodynamic instability, need for transfusion, need and duration of hospitalization, organ dysfunctions, and mortality were recorded. Perioperative cardiac events were recorded as non-fatal cardiac arrest, acute myocardial infarction (MI), congestive heart failure (CHF), new cardiac arrhythmia, and angina. Results: Cardiac morbidity and mortality were found in 38.7% and 1.1% of patients, respectively. Age and weight were higher in patients with perioperative cardiac morbidity (p<0.001). The ratio of coronary artery disease (CAD), HT, CHF, valvular heart disease, arrhythmia, hyperlipidemia, chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF), diabetes mellitus (DM), stroke, anemia, and cancer was higher in the perioperative cardiac morbidity group (p< 0.05). The frequency of arrhythmia, chronic Renal Failure (CRF), anemia, and neurodeficit after cerebrovascular accident (CVA) was higher in the group with perioperative mortality (p<0.05). Intraoperative and postoperative cardiac complication ratios were higher in the perioperative mortality group (p<0.05). Perioperative morbidity and mortality ratios were 20.6% and 0.5% in patients with cardiac disease, respectively. Age, advanced age, coronary artery disease (CAD), cancer, diuretic use, intraoperative use of total erythrocytes, and colloids were risk factors for perioperative morbidity. The presence of CRF and neurologic deficit after CVA was a risk factor for perioperative mortality (p<0.05). Conclusion: Age, presence of CAD, cancer, diuretics, and intraoperative fluid replacement were significant risk factors for perioperative cardiac morbidity. CRF and neurological deficits after CVA were identified as independent risk factors for perioperative mortality

Anahtar Kelimeler

• Surgical procedures
• Morbidity
• Mortality

Destekleyen Kurum

Yoktur

Etik Beyan

Ethical approval was obtained for the study, and the study was conducted in accordance with the Declaration of Helsinki.

Nonkardiyak Cerrahi Uygulanan Hastalarda Eşlik Eden Kardiyak Sorunlar ve Morbidite ve Mortalite Üzerine Etkileri

Öz

Amaç: Bu çalışmanın amacı non- kardiyak cerrahi geçiren hastalarda perioperatif kardiyak sorunların sıklığını ve bunların perioperatif kardiyak morbidite ve mortalite üzerine etkilerini belirlemektir. Gereç ve Yöntem: Non- kardiyak cerrahi sonrası postoperatif kliniklerde takip edilen hastalar değerlendirildi ve 3003 hasta analiz edildi. Ameliyat öncesi demografik ve klinik özellikler kaydedildi. Postoperatif dönemde hipotansiyon, bradikardi veya hemodinamik instabilite, transfüzyon ihtiyacı, hastanede yatış ihtiyacı ve süresi, organ disfonksiyonları ve mortalite kaydedildi. Perioperatif kardiyak olaylar ölümcül olmayan kardiyak arrest, akut miyokard enfarktüsü (MI), konjestif kalp yetmezliği (KKY), yeni kardiyak aritmi ve anjina olarak kaydedildi. Bulgular: Kardiyak morbidite ve mortalite sırasıyla hastaların %38,7'sinde ve %1,1'inde saptandı. Perioperatif kardiyak morbiditesi olan hastalarda yaş ve kilo daha yüksekti (p<0.001). Perioperatif kardiyak morbidite grubunda koroner arter hastalığı (KAH), HT, KKY, kalp kapak hastalığı, aritmi, hiperlipidemi, kronik obstrüktif akciğer hastalığı (KOAH), kronik böbrek yetmezliği (KBY), diabetes mellitus (DM), inme, anemi ve kanser oranı daha yüksekti (p< 0.05). Perioperatif mortalite görülen grupta aritmi, kronik böbrek yetmezliği (KBY), anemi ve serebrovasküler olay (SVO) sonrası nörodefisit sıklığı daha yüksekti (p<0.05). İntraoperatif ve postoperatif kardiyak komplikasyon oranları perioperatif mortalite grubunda daha yüksekti (p<0.05). Kardiyak hastalığı olan hastalarda perioperatif morbidite ve mortalite oranları sırasıyla %20,6 ve %0,5 idi. Yaş, ileri yaş, koroner arter hastalığı (KAH), kanser, diüretik kullanımı, intraoperatif total eritrosit ve kolloid kullanımı perioperatif morbidite için risk faktörleriydi. KBY ve SVO sonrası nörolojik defisit varlığı perioperatif mortalite için faktörüydü. (p<0.05). Sonuç: Yaş, KAH varlığı, kanser, diüretikler ve intraoperatif sıvı replasmanı perioperatif kardiyak morbidite için anlamlı risk faktörleriydi. KBY ve SVO sonrası nörolojik defisit ise perioperatif mortalite için bağımsız risk faktörleri olarak belirlenmiştir.

Anahtar Kelimeler

• Cerrahi işlemler
• Morbidite
• Mortalite

Destekleyen Kurum

None

Etik Beyan

Çalışma için etik onam alınmış ve çalışma Helsinki Deklarayonuna uygun olatrak yürütülmüştür

Kaynakça

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