Predictors of Cardiac Complications of Abdominal and Small Pelvic Surgery in Elderly and Senile Patients

Moroz, V. V.; Dobrushina, O.; Strelnikova, E. P.; Korniyenko, Aleksandr; Zinina, E.P.

doi:10.15360/1813-9779-2011-5-26

Cited by 8 publications

(1 citation statement)

References 11 publications

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“…Именно эти ИКР включены в большинство современных рекомендаций по риск-снижающей стратегии в некардиальной хирургии. Вместе с тем в отечественных исследованиях продемонстрировано, что ИКР Lee, а также значительно более сложные и трудоемкие для подсчета ИКР Goldman и ИКР Detsky не обеспечивают достаточной чувствитель ности и специфичности в предсказании госпиталь ных кардиальных осложнений у больных общехи рургического профиля [9]. Это вполне закономерно, учитывая ряд особенностей популяции отечествен ных больных, в частности низкую приверженность к профилактическим мероприятиям, нередко не достаточно эффективную и регулярную терапию и др.…”

Section: Discussionunclassified

Posthospital Cardiovascular Complications in Patients after Non-Cardiac Surgery

Соколов

Lyuboshevsky

Староверов

et al. 2021

Vestn. anesteziol. reanimatol.

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The objective: to analyze the incidence and spectrum of cardiovascular complications within 12 months after noncardiac surgery, as well as to assess the association of preoperative values of various cardiac risk indices (CRI) and other potential risk factors with the actual development of complications.Subjects and Methods. We analyzed data of medical records and telephone interviews of 141 patients aged 65 [60-71] years who had undergone non-cardiac surgery a year before the interview The operations were low risk in 13.5% of observations, medium risk in 64.5%, and high risk in 22%. A retrospective calculation of the Revised CRI (RCRI), Individual CRI (Khoronenko CRI), and the American College of Surgeons Perioperative Risk for Myocardial Infarction or Cardiac Arrest (MICA) was performed.Results. Cardiac events (myocardial infarction, decompensation of chronic heart failure, new arrhythmias, stroke, and/or the need to prescribe or escalate the dose of cardiovascular drugs and/or hospitalization for cardiac indications, and/or death from cardiovascular diseases) within 12 months after elective noncardiac surgeries were detected in 27.7% of cases, and in 2.1% of patient's death occurred due to cardiac disorders. Predictors of cardiac events were concomitant ischemic heart disease (OR = 2.777; 95% CI 1.286-5.966; p = 0.0093) and chronic heart failure (OR = 2.900; 95% CI 1.224-6.869; p = 0, 0155), RCRI (OR = 1.886; 95% CI 1.2-8-2.944; p = 0.005), Khoronenko CRI (OR = 3254.3; 95% CI 64.33-164,638; p = 0.0001), MICA (OR = 1.628; 95% CI 1.156-2.292; p = 0.005), creatininemia on the first postoperative day (OR = 1.023; 95% CI 1.010-1.061; p = 0.005), and propensity for bradycardia during surgery (OR = 0.945; 95% CI 0.908-0.983; p = 0.005). Combined analysis of Khoronenko's CRI and postoperative creatininemia provided a very good model: area under the ROC-curve - 0.823 (95% CI 0.728-0.641; p = 0.0002).Conclusion. All studied CRIs can be used to predict posthospital cardiac events; however, the most promising is a joint assessment of Khoronenko's CRI and postoperative creatinemia.

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Section: Discussionunclassified

Posthospital Cardiovascular Complications in Patients after Non-Cardiac Surgery

Соколов

Lyuboshevsky

Староверов

et al. 2021

Vestn. anesteziol. reanimatol.

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Perioperative Myocardial Damage and Heart Failure in Noncardiac Surgery. Part 1. Etiopathogenesis and Prognosis of Perioperative Cardiac Complications (Review)

Kozlov

Овезов

Петровская

2019

Obŝaâ reanimatologiâ

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The purpose of this paper is to provide scientific and practical information on assessment of the risk of myocardical damage development after noncardiac operations (NOMD): ischemia or myocardial infarction (MI), and/or heart failure (HF) and their prevention in adult patients. This overview of literature consists of two parts. The first part analyzes epidemiology, etiopathogeneis, and POCC risk prediction methods; the second part describes the possibilities of adjuvant pharmacological cardioprotection and approaches to optimizing anesthesiological support of operative interventions in high cardiac risk patients.The problem of perioperative cardiac complications in noncardiac surgey is one of relevant complex issues of contemporary medicine. In line with contemporary views, NOMD is now regarded as a separate variant of a pathological process in the heart muscle. According to extensive studies, about 40% of mortality of adult patients during non-cardial operative inverventions are caused by various NOMD and/or HF. The problem under discussion is particularly relevant when medical assistance is rendered to elderly patients.

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Perioperative Myocardial Damage and Heart Failure in Noncardiac Surgery. Part 2. Reduction of the Risk of Perioperative Cardiac Complications by Pharmacological Measures and Optimization of Anesthetic and Critical Care Support (Review)

Kozlov

Овезов

Петровская

2019

Obŝaâ reanimatologiâ

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The second part of the overview presents and analyzes the current data on the methods of adjuvant pharmacological cardioprotection and possibilities of optimizing the anesthetic support and perioperative monitoring in high cardiac risk patients. Amendments made in international guidelines for the last 2–3 years on the basis of conclusive studies and meta-analyses have been examined. Cardioprotection mechanisms and information about its implementation in real clinical practice have been analysed. It has been shown that by no means all drugs under discussion can be widely used for prophytlactic purposes. Contemporary evidencebased recommendations concerning the optimization of anesthetic support and perioperative monitoring are given. A conclusion has been made that practical implementation of a comprehensive strategy aimed at reduction of the risk of cardiac complications might ensure decrease of both the incidence of severe cardiac complications and mortality due to them.

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Predictors of Cardiac Complications of Abdominal and Small Pelvic Surgery in Elderly and Senile Patients

Cited by 8 publications

References 11 publications

Posthospital Cardiovascular Complications in Patients after Non-Cardiac Surgery

Posthospital Cardiovascular Complications in Patients after Non-Cardiac Surgery

Perioperative Myocardial Damage and Heart Failure in Noncardiac Surgery. Part 1. Etiopathogenesis and Prognosis of Perioperative Cardiac Complications (Review)

Perioperative Myocardial Damage and Heart Failure in Noncardiac Surgery. Part 2. Reduction of the Risk of Perioperative Cardiac Complications by Pharmacological Measures and Optimization of Anesthetic and Critical Care Support (Review)

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