AI Article Synopsis
- The study aimed to find out if lower left ventricular systolic function (LVEF) increases the risk of postoperative complications during noncardiac surgeries.
- Analyzing data from 1,692 patients who had preoperative echocardiograms, the research found that postoperative infections were the most common complications, with respiratory and renal issues being less frequent.
- The results indicated that lower preoperative LVEF is linked to a higher chance of postoperative infections and renal complications but not respiratory ones, suggesting the importance of LVEF assessment before surgery.
Article Abstract
Objective: We sought to determine if decreased left ventricular systolic function was associated with an increased risk of postoperative infectious, respiratory, or renal complications in patients undergoing noncardiac surgery.
Design: Retrospective cohort study.
Setting: Single tertiary-care, university-based medical center.
Patients: We studied individuals who participated in the American College of Surgeons National Quality Improvement Program and had a preoperative echocardiogram conducted at our institution.
Interventions: None.
Measurements: The incidences of postoperative respiratory (need for postoperative mechanical ventilation or unplanned intubation), renal (acute renal failure or renal insufficiency), and infectious (pneumonia, urinary tract infection, sepsis, or wound infection) complications were analyzed.
Main Results: Postoperative infections (n=175, 10%) represented the most common postoperative complication seen in the study population of 1692 individuals. Respiratory complications occurred in 77 (5%) and renal complications occurred in 29 (2%) participants. The time between the echocardiogram and surgery ranged from 7 months (interquartile range [IQR] 1.8-15.7) for those with severely reduced left ventricular ejection fraction (LVEF) to 24 months (IQR 2.5-38.6) for those with a normal LVEF (P=.038). Univariate analysis demonstrated a relationship between decreased preoperative LVEF and infectious and renal complications, but not respiratory complications. After adjusting for preoperative characteristics, decreased preoperative LVEF was associated with infectious (odds ratio, 1.33; 95% confidence interval, 1.03-1.68; P=.0265) and renal (odds ratio, 1.69; 95% confidence interval, 1.12-2.48; P=.0142) complications.
Conclusions: Decreased preoperative LVEF is associated with postoperative infections and renal complications.
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| http://dx.doi.org/10.1016/j.jclinane.2016.08.038 | DOI Listing |
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