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Predictors of major postoperative cardiac complications in a surgical ICU.
Rev Port Cardiol. 2008 Mar; 27(3):321-8.RP

Abstract

INTRODUCTION

Cardiovascular complications are associated with increased mortality and morbidity during the postoperative period, resulting in longer hospital stay and higher treatment costs.

OBJECTIVES

The aim of this study was to identify predictors of major postoperative cardiac complications.

METHODS

187 patients undergoing noncardiac surgery, admitted to a surgical intensive care unit (ICU) between November 2004 and April 2005. Variables recorded were age, gender, American Society of Anesthesiologists (ASA) physical status, type and magnitude of surgery, mortality, ICU and hospital length of stay (LOS), Simplified Acute Physiology Score II (SAPS II), cardiac troponin I (cTnI) at postoperative day 0, 1, 2 and 3, history of hypertension, hyperlipidemia, Revised Cardiac Risk Index (RCRI) score, major cardiac events (MCE): acute myocardial infarction (AMI), pulmonary edema (PE), ventricular fibrillation (VF) or primary cardiac arrest (PCA). Correlations between variables and MCE were made by univariate analysis by simple logistic regression with odds ratio (OR) and 95% confidence interval (95% CI).

RESULTS

Total of 14 MCE: 9 AMI, 1 VF, 4 PE. Significant risk factors for MCE were high-risk surgery (OR 8.26, 95% CI 1.76-38.85, p = 0.008), RCRI > or = 2 (OR 4.0, 95% CI 1.22-13.16, p = 0.022), admission cTnI (OR 1.46, 95% CI 1.07-1.99, p = 0.018); day 1 cTnI (OR 1.75, 95% CI 1.27-2.41, p = 0.001); day 2 cTnI (OR 2.23, 95% CI 1.24-3.98, p = 0.007), SAPS II (OR 1.08, 95% CI 1.04-1.12, p < 0.001). Patients with MCE had longer ICU LOS (19.1 +/- 19.3 days against 3.4 +/- 4.9) (OR 1.15, 95% CI 1.08-1.22, p < 0.001) and higher ICU mortality (21.4% versus 4.6%) (OR 5.63, 95% CI 1.31-24.23, p = 0.02) in the ICU.

CONCLUSIONS

High-risk surgery, RCRI > or = 2, cTnI levels and SAPS II were predictors of postoperative MCE. Patients with MCE had longer ICU stay and higher mortality rate.

Authors+Show Affiliations

Department of Anesthesia, Hospital de S. João, Porto, Portugal. paulacmaiaster@gmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18551918

Citation

Maia, Paula C., and Fernando J. Abelha. "Predictors of Major Postoperative Cardiac Complications in a Surgical ICU." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 27, no. 3, 2008, pp. 321-8.
Maia PC, Abelha FJ. Predictors of major postoperative cardiac complications in a surgical ICU. Rev Port Cardiol. 2008;27(3):321-8.
Maia, P. C., & Abelha, F. J. (2008). Predictors of major postoperative cardiac complications in a surgical ICU. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 27(3), 321-8.
Maia PC, Abelha FJ. Predictors of Major Postoperative Cardiac Complications in a Surgical ICU. Rev Port Cardiol. 2008;27(3):321-8. PubMed PMID: 18551918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of major postoperative cardiac complications in a surgical ICU. AU - Maia,Paula C, AU - Abelha,Fernando J, PY - 2008/6/17/pubmed PY - 2008/9/16/medline PY - 2008/6/17/entrez SP - 321 EP - 8 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 27 IS - 3 N2 - INTRODUCTION: Cardiovascular complications are associated with increased mortality and morbidity during the postoperative period, resulting in longer hospital stay and higher treatment costs. OBJECTIVES: The aim of this study was to identify predictors of major postoperative cardiac complications. METHODS: 187 patients undergoing noncardiac surgery, admitted to a surgical intensive care unit (ICU) between November 2004 and April 2005. Variables recorded were age, gender, American Society of Anesthesiologists (ASA) physical status, type and magnitude of surgery, mortality, ICU and hospital length of stay (LOS), Simplified Acute Physiology Score II (SAPS II), cardiac troponin I (cTnI) at postoperative day 0, 1, 2 and 3, history of hypertension, hyperlipidemia, Revised Cardiac Risk Index (RCRI) score, major cardiac events (MCE): acute myocardial infarction (AMI), pulmonary edema (PE), ventricular fibrillation (VF) or primary cardiac arrest (PCA). Correlations between variables and MCE were made by univariate analysis by simple logistic regression with odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: Total of 14 MCE: 9 AMI, 1 VF, 4 PE. Significant risk factors for MCE were high-risk surgery (OR 8.26, 95% CI 1.76-38.85, p = 0.008), RCRI > or = 2 (OR 4.0, 95% CI 1.22-13.16, p = 0.022), admission cTnI (OR 1.46, 95% CI 1.07-1.99, p = 0.018); day 1 cTnI (OR 1.75, 95% CI 1.27-2.41, p = 0.001); day 2 cTnI (OR 2.23, 95% CI 1.24-3.98, p = 0.007), SAPS II (OR 1.08, 95% CI 1.04-1.12, p < 0.001). Patients with MCE had longer ICU LOS (19.1 +/- 19.3 days against 3.4 +/- 4.9) (OR 1.15, 95% CI 1.08-1.22, p < 0.001) and higher ICU mortality (21.4% versus 4.6%) (OR 5.63, 95% CI 1.31-24.23, p = 0.02) in the ICU. CONCLUSIONS: High-risk surgery, RCRI > or = 2, cTnI levels and SAPS II were predictors of postoperative MCE. Patients with MCE had longer ICU stay and higher mortality rate. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/18551918/Predictors_of_major_postoperative_cardiac_complications_in_a_surgical_ICU_ L2 - https://medlineplus.gov/surgery.html DB - PRIME DP - Unbound Medicine ER -