The cardiac disease ratio in the patients who are operated due to non-cardiac surgery and to specify whether such cardiac problems have an effect on perioperative cardiac morbidity and mortality or not

ABSTRACT Quantity of non-cardiac surgery has increased by the increasing population and prolongation of lifetime in the world. Prolongation of lifetime has also increase the co-morbid diseases in the patients requiring surgical intervention. Together with co-morbid diseases, perioperative morbidity and mortality ratios also show an increase. One of the most common reasons of perioperatively observed morbidity and mortality is cardiac complications. In this study, it is aimed to determine the cardiac disease ratio in the patients who are operated due to non-cardiac surgery and to specify retrospectively whether such cardiac problems have an effect on perioperative cardiac morbidity and mortality or not. After the approval of Başkent University Research Board of Medicine and Health Sciences is received, 3003 patients over 18 years olf who had non-cardiac surgery at Başkent University Ankara Hospital between May 2012 and June 2013 were examined retrospectively. Demographical properties, accompanying diseases, drugs used, data during operation (anesthesia type, type of surgical intervention, vital findings, crystalloids used and colloid quantities, blood and blood product replacement, hemodynamic complications occurred), post operation data (hemodynamic complications within the first 48 hours, presence of mortality within the first 48 hours, intensive care requirement and duration of stay, hospitalization period) of the patients were recorded. From 3003 patients included in the study; cardiac mortality was observed in 32 (%1,1) and cardiac morbidity was observed in 1163 (%38,7). Cardiac diseases were found in 1183 patients among all the patients (%39,4). Perioperative morbidity was found in 588 (%19,6) and perioperative mortality was found in 16 (%0,5) of the patients with cardiac diseases. It is found that the presence of advanced age, body weight, coronary artery disease, hypertension, congestive heart failure, valvular cardiac valve disease, arrhythmia, hyperlipidemia, chronic obstructive lung disease, chronic kidney disease, diabetes mellitus, stroke, anemia, coagulopathy and cancer; usage of beta blockers, diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitor, angiotensin receptor blockers, vasodilator, anticoagulant, antithrombotic, statin, oral anti-diabetics, insulin, anti-thyroid and bronchodilator; classification of American Society of Anesthesiology (ASA); general surgery, ear-nose-throat and thoracic surgery; quantities of total crystalloids, colloid, erythrocyte suspension and fresh frozen plasma have a statistically significant effect on perioperative cardiac morbidity frequency (p<0,05 for all). It is found that arrhythmia, chronic kidney failure, anemia and neurodeficiency have an effect on perioperative mortality frequency (p<0,05 for all). As a result; among all the parameters, it is found that age, advanced age, coronary artery disease, cancer, usage of diuretics, ASA, intraoperative used total erythrocyte and colloid quantity are found as risk factors for perioperative cardiac morbidity in the patients who had non-cardiac surgery. For perioperative cardiac mortality; chronic kidney failure and neurodeficiency are found as the risk factors. In patients who had non-cardiac surgery; it is suggested that perioperative cardiac complication frequency can be reduced by changing or improving the recoverable risk factors that we have specified for perioperative cardiac morbidity and mortality. Key words; non-cardiac surgery, perioperative cardiac morbidity, perioperative cardiac mortality, risk factors