2016, Number 1
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ABSTRACTIntroduction: Postoperative cardiovascular complications are disorders associated with bad outcomes.
Objectives: To identify the factors related with cardiovascular complication and its influence on clinical outcomes in patients operated for cancer.
Methods: A prospective study from 426 consecutive patients operated for cancer and admitted in Intensive Care Unit. It were assessed the possible risk factors related with cardiovascular complications; after that, was analyzed the influence of cardiovascular complication on clinical outcomes.
Results: Cardiovascular complications appeared in 35 patients (8,2%). Two factors on the Revised Cardiac Risk Index (OR 15,21 [95% CI 4,18-55,30]; p ‹ 0,0001), as well as thoracic surgery (OR 6,52 [95% CI 1,13-37,71]; p= 0,036) and gastrointestinal surgery (OR 6,54 [95% CI 1,38-31,08]; p= 0,018) were independently associated with cardiovascular complications. Development at least one cardiovascular complication (OR 13,40 [95% CI 3,58-50,25]; p ‹ 0,0001), cardiac arrest (OR 39,27 [95% CI 1,63-944,53]; p= 0,024) and acute heart failure (OR 32,79 [95% CI 2,42-444,28]; p= 0,009) were factors related with hospital mortality in multivariate logistic regression analysis.
Conclusions: The Revised Cardiac Risk Index, thoracic surgery and gastrointestinal surgery are factors linked with postoperative cardiovascular complications. This events increase hospital mortality.
Devereaux PJ, Xavier D, Pogue J, Guyatt G, Sigamani A, Garut-ti I, Leslie K, Rao-Melacini P, Chrolavicius S, Yang H, Macdo-nald C, Avezum A, Lanthier L, Hu W, Yusuf S; POISE (Peri-Operative ISchemic Evaluation) Investigators. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011; 154: 523-8.
Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, et al. Management of Massive and Submas-sive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Association. Cir-culation. 2011; 123: 1788-830.
McMurray JJV, AdamopoulosS, Anker SD, Auricchio A, BöhmM, Dickstein K, et al. ESC Guidelines for the diagnosis and treatmentof acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. De-veloped in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012; 33: 1787-847.
The Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION) Writing Group, on behalf of The Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VI-SION) Investigators. Myocardial Injury after Noncardiac Sur-gery. A Large, International, Prospective Cohort Study Estab-lishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes. Anesthesiology. 2014; 120: 564-78.
Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Fleischmann KE, et al. 2009 ACCF/AHA focused update on pe-rioperative beta blockade incorporated into the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Car-diology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009; 120: e169-e276.
Vascular Events In Noncardiac Surgery Patients Cohort Evalua-tion (VISION) Study Investigators, Devereaux PJ, Chan MT, Alonso-Coello P, Walsh M, Berwanger O, et al. Association be-tween postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA. 2012; 307: 2295-304.