Survival curve identifies critical period for postoperative mortality in cardiac patients undergoing emergency general surgery

Abstract

The number of non-cardiac major surgeries carried out has significantly increased in recent years to around 200 million procedures carried out annually. Approximately 30% of patients submitted to non-cardiac surgery present some form of cardiovascular comorbidity. In emergency situations, with less surgery planning time and greater clinical severity, the risks become even more significant. The aim of this study is to determine the incidence and clinical outcomes in patients with cardiovascular disease submitted to non-cardiac surgical procedures in a single cardiovascular referral center. This is a prospective cohort study of patients with cardiovascular disease submitted to non-cardiovascular surgery. All procedures were carried out by the same surgeon, between January 2006 and January 2018. 240 patients included were elderly, 154 were male (64%), 8 patients presented two diagnoses. Of the resulting 248 procedures carried out, 230 were emergency (92.8%). From the data obtained it was possible to estimate the day from which the occurrence of mortality is less probable in the postoperative phase. Our research evaluated the epidemiological profile of the surgeries and we were able to estimate the survival and delimit the period of greatest risk of mortality in these patients. The high rate of acute mesenteric ischemia was notable, a serious and frequently fatal condition.

Cirrhosis and hernia repair in a cohort of 6352 patients in a tertiary hospital: Risk assessment and survival analysis

“…This is 10 times greater than the incidence of UH in the general population. [ 1 , 7 ] This high prevalence is essentially due to the presence of ascites, attenuation of the abdominal wall and malnutrition. [ 1 , 5 ] The onset of UH generally corresponds to the presence or history of ascites and, consequently, is associated with altered hepatocellular function.…”

“…[13][14][15] Thus, there is a vast literature on patients with cirrhosis evaluating hernia repair that shows a wide range of morbidity and mortality rates. [7,16] However, there are few studies addressing the epidemiology of these hernias that consider how different cirrhosis etiologies could be related to the various clinical presentations and prognosis.…”