Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery

Hsien Yuan Chang, Wei Ting Chang, Yen Wen Liu

研究成果: Article

摘要

Background Cardiovascular events are the leading cause of perioperative complications among patients undergoing noncardiac surgery. However, the role of echocardiography for preoperative cardiac risk stratification prior to major noncardiac surgery is still controversial. Methods This retrospective study included a total of 1453 patients (51% male; age, 67 ± 16) who underwent intermediate- or high-risk major abdominal surgery or orthopedic surgery at two medical centers in South Taiwan between February 2013 and June 2016. All patients underwent preoperative transthoracic echocardiography (TTE). All of the included patients were followed up for 56 days after surgery. The primary endpoints were major adverse events (MAEs), i.e., all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs). Results A total of 35 patients (2.4%) reached the primary endpoint: 24 patients (1.6%) died, and 17 patients (1.2%) had MACCEs. Patients with postsurgery MAEs had higher average E/e’ values, a lower Left ventricular (LV) ejection fraction, and higher prevalence of significant mitral regurgitation (MR) and moderate-advanced chronic kidney disease (CKD). Multivariate analysis showed that the modified Lee index and significant MR were independent prognostic predictors of MAEs. Conclusion Preoperative identification of significant MR on TTE is associated with increased MAEs at 56 days compared with that predicted by the modified Lee index alone in patients undergoing intermediate- or high-risk noncardiac surgery.

原文English
文章編號e0215854
期刊PloS one
14
發行號4
DOIs
出版狀態Published - 2019 四月

指紋

Echocardiography
echocardiography
Surgery
surgery
Mitral Valve Insufficiency
endpoints
Orthopedics
orthopedics
kidney diseases
Ambulatory Surgical Procedures
Taiwan
Chronic Renal Insufficiency
retrospective studies
Stroke Volume
multivariate analysis
Multivariate Analysis
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

引用此文

@article{cb8f18f202984160aedc5740e72e3c30,
title = "Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery",
abstract = "Background Cardiovascular events are the leading cause of perioperative complications among patients undergoing noncardiac surgery. However, the role of echocardiography for preoperative cardiac risk stratification prior to major noncardiac surgery is still controversial. Methods This retrospective study included a total of 1453 patients (51{\%} male; age, 67 ± 16) who underwent intermediate- or high-risk major abdominal surgery or orthopedic surgery at two medical centers in South Taiwan between February 2013 and June 2016. All patients underwent preoperative transthoracic echocardiography (TTE). All of the included patients were followed up for 56 days after surgery. The primary endpoints were major adverse events (MAEs), i.e., all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs). Results A total of 35 patients (2.4{\%}) reached the primary endpoint: 24 patients (1.6{\%}) died, and 17 patients (1.2{\%}) had MACCEs. Patients with postsurgery MAEs had higher average E/e’ values, a lower Left ventricular (LV) ejection fraction, and higher prevalence of significant mitral regurgitation (MR) and moderate-advanced chronic kidney disease (CKD). Multivariate analysis showed that the modified Lee index and significant MR were independent prognostic predictors of MAEs. Conclusion Preoperative identification of significant MR on TTE is associated with increased MAEs at 56 days compared with that predicted by the modified Lee index alone in patients undergoing intermediate- or high-risk noncardiac surgery.",
author = "Chang, {Hsien Yuan} and Chang, {Wei Ting} and Liu, {Yen Wen}",
year = "2019",
month = "4",
doi = "10.1371/journal.pone.0215854",
language = "English",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "4",

}

Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery. / Chang, Hsien Yuan; Chang, Wei Ting; Liu, Yen Wen.

於: PloS one, 卷 14, 編號 4, e0215854, 04.2019.

研究成果: Article

TY - JOUR

T1 - Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery

AU - Chang, Hsien Yuan

AU - Chang, Wei Ting

AU - Liu, Yen Wen

PY - 2019/4

Y1 - 2019/4

N2 - Background Cardiovascular events are the leading cause of perioperative complications among patients undergoing noncardiac surgery. However, the role of echocardiography for preoperative cardiac risk stratification prior to major noncardiac surgery is still controversial. Methods This retrospective study included a total of 1453 patients (51% male; age, 67 ± 16) who underwent intermediate- or high-risk major abdominal surgery or orthopedic surgery at two medical centers in South Taiwan between February 2013 and June 2016. All patients underwent preoperative transthoracic echocardiography (TTE). All of the included patients were followed up for 56 days after surgery. The primary endpoints were major adverse events (MAEs), i.e., all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs). Results A total of 35 patients (2.4%) reached the primary endpoint: 24 patients (1.6%) died, and 17 patients (1.2%) had MACCEs. Patients with postsurgery MAEs had higher average E/e’ values, a lower Left ventricular (LV) ejection fraction, and higher prevalence of significant mitral regurgitation (MR) and moderate-advanced chronic kidney disease (CKD). Multivariate analysis showed that the modified Lee index and significant MR were independent prognostic predictors of MAEs. Conclusion Preoperative identification of significant MR on TTE is associated with increased MAEs at 56 days compared with that predicted by the modified Lee index alone in patients undergoing intermediate- or high-risk noncardiac surgery.

AB - Background Cardiovascular events are the leading cause of perioperative complications among patients undergoing noncardiac surgery. However, the role of echocardiography for preoperative cardiac risk stratification prior to major noncardiac surgery is still controversial. Methods This retrospective study included a total of 1453 patients (51% male; age, 67 ± 16) who underwent intermediate- or high-risk major abdominal surgery or orthopedic surgery at two medical centers in South Taiwan between February 2013 and June 2016. All patients underwent preoperative transthoracic echocardiography (TTE). All of the included patients were followed up for 56 days after surgery. The primary endpoints were major adverse events (MAEs), i.e., all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs). Results A total of 35 patients (2.4%) reached the primary endpoint: 24 patients (1.6%) died, and 17 patients (1.2%) had MACCEs. Patients with postsurgery MAEs had higher average E/e’ values, a lower Left ventricular (LV) ejection fraction, and higher prevalence of significant mitral regurgitation (MR) and moderate-advanced chronic kidney disease (CKD). Multivariate analysis showed that the modified Lee index and significant MR were independent prognostic predictors of MAEs. Conclusion Preoperative identification of significant MR on TTE is associated with increased MAEs at 56 days compared with that predicted by the modified Lee index alone in patients undergoing intermediate- or high-risk noncardiac surgery.

UR - http://www.scopus.com/inward/record.url?scp=85064862084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064862084&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0215854

DO - 10.1371/journal.pone.0215854

M3 - Article

C2 - 31022210

AN - SCOPUS:85064862084

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 4

M1 - e0215854

ER -