Perioperative adverse cardiac events and mortality after non-cardiac surgery: a multicenter studyopen accessPerioperative adverse cardiac events and mortality after non-cardiac surgery: a multicenter study
- Other Titles
- Perioperative adverse cardiac events and mortality after non-cardiac surgery: a multicenter study
- Authors
- Choi, Byungjin; Oh, Ah Ran; Park, Jungchan; Lee, Jong-Hwan; Yang, Kwangmo; Lee, Dong Yun; Rhee, Sang Youl; Kang, Sang-Soo; Lee, Seung Do; Lee, Sun Hack; Jeong, Chang Won; Park, Bumhee; Seol, Soobeen; Park, Rae Woong; Lee, Seunghwa
- Issue Date
- Feb-2024
- Publisher
- Korean Society of Anesthesiologists
- Keywords
- Cardiac arrhythmias; Cardiovascular diseases; Embolism; General surgery; Mortality; Myocardial infarction
- Citation
- Korean Journal of Anesthesiology, v.77, no.1, pp 66 - 76
- Pages
- 11
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Korean Journal of Anesthesiology
- Volume
- 77
- Number
- 1
- Start Page
- 66
- End Page
- 76
- URI
- https://scholarworks.gnu.ac.kr/handle/sw.gnu/69678
- DOI
- 10.4097/kja.23043
- ISSN
- 2005-6419
2005-7563
- Abstract
- Background: Perioperative adverse cardiac events (PACE), a composite of myocardial in-farction, coronary revascularization, congestive heart failure, arrhythmic attack, acute pulmonary embolism, cardiac arrest, and stroke during 30-day postoperative period, is associated with long-term mortality, but with limited clinical evidence. We compared long-term mortality with PACE using data from nationwide multicenter electronic health re-cords. Methods: Data from 7 hospitals, converted to Observational Medical Outcomes Partner-ship Common Data Model, were used. We extracted records of 277,787 adult patients over 18 years old undergoing non-cardiac surgery for the first time at the hospital and had medical records for more than 180 days before surgery. We performed propensity score matching and then an aggregated meta-analysis. Results: After 1:4 propensity score matching, 7,970 patients with PACE and 28,807 patients without PACE were matched. The meta-analysis showed that PACE was associated with higher one-year mortality risk (hazard ratio [HR]: 1.33, 95% CI [1.10, 1.60], P = 0.005) and higher three-year mortality (HR: 1.18, 95% CI [1.01, 1.38], P = 0.038). In sub-group analysis, the risk of one-year mortality by PACE became greater with higher-risk surgical procedures (HR: 1.20, 95% CI [1.04, 1.39], P = 0.020 for low-risk surgery; HR: 1.69, 95% CI [1.45, 1.96], P < 0.001 for intermediate-risk; and HR: 2.38, 95% CI [1.47, 3.86], P = 0.034 for high-risk). Conclusions: A nationwide multicenter study showed that PACE was significantly associated with increased one-year mortality. This association was stronger the older age group, emergency surgery group, and high surgical risk group. Further studies to improve mortality associated with PACE are needed. © The Korean Society of Anesthesiologists, 2024.
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