Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery

Smeili, Luciana Andréa Avena; Lotufo, Paulo A.

doi:10.5935/abc.20150113

Cited by 15 publications

(10 citation statements)

References 29 publications

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“…Several papers in the literature have compared the accuracy of existing indices for different populations of surgical patients. 42 - 44 Most of these studies show that the various existing indices, although not very accurate, can predict events and should be used in perioperative assessment.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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Section: Preoperative Evaluationmentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“…The performance of the scores was better than previously reported in earlier studies. 24,25 All use serum creatinine to define chronic kidney disease, but they may be updated to use creatinine clearance in the near future. 26 Prediction is also influenced by the correct measurement of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

Major Cardiac Events in Patients Admitted to Intensive Care After Vascular Noncardiac Surgery: A Retrospective Cohort

Reis

Lopes

Leite

et al. 2019

Semin Cardiothorac Vasc Anesth

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Introduction. Patients proposed to vascular noncardiac surgery (VS) have several comorbidities associated with major adverse cardiac events (MACE). We evaluated incidence, predictors, and outcomes, and compared different scores to predict MACE after VS. Methods. We included all patients admitted from 2006 to 2013. Perioperative MACE included cardiac arrhythmias, myocardial infarction (MI), cardiogenic pulmonary edema (CPE), acute heart failure (AHF), and cardiac arrest (CA). Lee Revised Cardiac Risk Index (RCRI), Vascular Quality Initiative (VQI-CRI), Vascular Study Group of New England (VSG-CRI), and South African Vascular Surgical (SAVS-CRI) Cardiac Risk Indexes were calculated and analyzed. We performed multivariate logistic regression to assess independent predictors with calculation of odds ratio (OR) and 95% confidence interval (CI). To reduce overfitting, we used leave-one-out cross-validation approach. The Predictive ability of scores was tested using area under receiver operating characteristic curve (AUROC). Results. A total of 928 patients were included. We observed 81 MACE (28 MI, 22 arrhythmias, 10 CPE, 9 AHF, 12 CA) in 60 patients (6.5%): 3.3% in intermediate-risk surgery and 9.8% in high-risk surgery. Previous history of coronary artery disease (OR = 3.2, CI = 1.8-5.7), atrial fibrillation (OR = 5.1, CI = 2.4-11.0), insulin-treated diabetes mellitus (OR = 3.26, CI = 1.51-7.06), mechanical ventilation (OR = 2.75, CI = 1.41-4.63), and heart rate (OR = 1.02, CI = 1.01-1.03) at admission were considered independent risk factors in multivariate analysis. The AUROC of our model was 0.79, compared with RCRI (0.66), VSG-CRI (0.69), VQI-CRI (0.71), and SAVS-CRI (0.73). Conclusions. Observed MACE were within predicted range (1% to 5% after intermediate-risk surgery and >5% after high-risk surgery). SAVS-CRI and VQI-CRI had slightly better predictive capacity than VSG-CRI or RCRI.

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“…Similarly, it was observed that there was no correlation between smoking, chronic obstructive pulmonary disease and reintubation. ( 2 , 12 , 13 )…”

Section: Discussionmentioning

confidence: 99%

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

Shoji¹,

Figuereido²,

Calixtre³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectivesTo analyze patients after cardiac surgery that needed endotracheal reintubation and identify factors associated with death and its relation with the severity scores.MethodsRetrospective analysis of information of 1,640 patients in the postoperative period of cardiac surgery between 2007 and 2015.ResultsThe reintubation rate was 7.26%. Of those who were reintubated, 36 (30.3%) underwent coronary artery bypass surgery, 27 (22.7%) underwent valve replacement, 25 (21.0%) underwent correction of an aneurysm, and 8 (6.7%) underwent a heart transplant. Among those with comorbidities, 54 (51.9%) were hypertensive, 22 (21.2%) were diabetic, and 10 (9.6%) had lung diseases. Among those who had complications, 61 (52.6%) had pneumonia, 50 (42.4%) developed renal failure, and 49 (51.0%) had a moderate form of the transient disturbance of gas exchange. Noninvasive ventilation was performed in 53 (44.5%) patients. The death rate was 40.3%, and mortality was higher in the group that did not receive noninvasive ventilation before reintubation (53.5%). Within the reintubated patients who died, the SOFA and APACHE II values were 7.9 ± 3.0 and 16.9 ± 4.5, respectively. Most of the reintubated patients (47.5%) belonged to the high-risk group, EuroSCORE (> 6 points).ConclusionThe reintubation rate was high, and it was related to worse SOFA, APACHE II and EuroSCORE scores. Mortality was higher in the group that did not receive noninvasive ventilation before reintubation.

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Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery

Cited by 15 publications

References 29 publications

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Major Cardiac Events in Patients Admitted to Intensive Care After Vascular Noncardiac Surgery: A Retrospective Cohort

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

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