Incidence and Risk Factors for Perioperative Cardiovascular Complications in Spine Surgery

Abstract

Background: An increasing number of patients are opting for spine surgery despite the associated risk of cardiovascular complications. The evidence regarding the incidence and risk factors of cardiovascular complications in spine surgery is insufficient. Therefore, we aimed to determine the incidence and risk factors for cardiovascular complications that occur perioperatively in spine surgery. Methods: This retrospective study included all patients who underwent spine surgery between January 2018 and December 2019 at a single center. Demographic, clinical, and operative data were collected from electronic medical records. The incidence of perioperative cardiac complications was determined. Univariate and multivariate analyses were performed to identify risk factors for the development of perioperative cardiovascular complications in the participants. Results: Of the 1,002 eligible patients enrolled in the study, six developed cardiac complications. Acute myocardial infarction, cardiac arrest, and congestive heart failure occurred in one, two, and three patients, respectively. Risk factors for cardiovascular complications included scoliosis surgery (odds ratios (OR): 18.61; 95% confidence interval (CI): 1.346-257.35) and a history of congestive heart failure (OR: 120.97; 95% CI: 2.12-6898.80). Conclusion: The incidence of perioperative cardiovascular complications in patients who underwent spine surgery was 0.6%. High-risk patients should be closely monitored optimally managed throughout the perioperative period.

Effectiveness of Preoperative Red Cell Preparation and Intraoperative Massive Transfusion in Brain Tumor Operation

“…Moreover, the endoscopic transsphenoidal approach had the C/T ratio, Tp, and Ti of 11, 7%, and 0.4, respectively, whereas those for the tumor biopsy had a C/T ratio, Tp, and Ti of 12, 8%, and 0.2, respectively. 3 According to the findings of tumor classification, surgery of meningiomas had effective indexes. The concordance results were similar to what had been shown in the Saringcarinkul and Chuasuwan study, which reported the Tp of patients with meningiomas was 49%.…”

“…However, an overabundance of requests for blood preparation has been observed in prior studies, particularly packed red cells (PRCs). 1 2 3 4 Chotisukarat et al found that the crossmatch to transfusion (C/T) ratio was 4.3% in 1,018 individuals who had elective neurosurgery operations. 3 Additionally, Saringcarinkul and Chuasuwan also studied 377 patients who had undergone neurosurgical operations and reported a high C/T ratio of 6.6.…”

“…5 6 Therefore, the request for more units of preoperative blood products for the patient's safety has been observed. 3 4 Nevertheless, the unnecessary blood products that were prepared led to the loss of resources and an increase in the amount of labor done in blood banks. Hence, the preoperative preparation of blood ought to optimize the potential benefit from the tradeoff between unexpectedly massive blood losses and blood waste.…”

Management of Patients with Ischemic Heart Disease in Spine Surgery

“…Several studies have reported risk factors for cardiovascular complications following spine surgery, including old age, diabetes, underlying heart disease, and anemia [5,11,24,[31][32][33]. In 2021, Ton et al [34] reported valid factors among modifiable risk factors (MRFs) for postoperative complications in 297,579 patients who underwent lumbar spine fusion surgery.…”

Lesión miocárdica e infarto al miocardio perioperatorio en cirugía de columna vertebral y ortopédica compleja

“…[17][18][19][20] De esta manera, al considerar la cirugía de columna lumbar como el procedimiento más frecuente y basarnos en tres grandes estudios sobre complicaciones cardiacas perioperatorias, mismos que contaron con 1,002, 30,339 y 105,505 pacientes, respectivamente, se encontró una incidencia para infarto de miocardio que va de 0.34 a 0.63% dentro de los primeros 30 días del postoperatorio. [21][22][23] En otro estudio, los pacientes que se sometieron a cirugías de fusión vertebral tuvieron una incidencia de IAM de 0.77%, mientras que los pacientes sometidos a procedimientos lumbares sin fusión tuvieron una incidencia de 0.45% (p < 0.001), como consecuencia de que la primera requiere mayor tiempo quirúrgico por su complejidad incrementada y mayor sangrado. 23 Los factores de riesgo para el desarrollo de complicaciones cardiacas observados fueron: una edad mayor a 80 años, diabetes mellitus tipo 2 (DM2), anemia preoperatoria, antecedentes de trastornos cardiacos, sexo masculino y un índice de comorbilidad de Charlson > 3.…”