Key result
Elevated-risk noncardiac surgery is linked to ~215% higher 30-day MACE risk versus low-risk surgery.
Why the study?
As surgical techniques evolve and patient outcomes improve over time, a renewed analysis to investigate and categorize the cardiac risk of elective noncardiac surgeries was needed.
Does the risk category of elective noncardiac surgery predict the incidence of 30-day postoperative major adverse cardiac events?
Cohort (n=807,413)
Yes
Does the risk category of elective noncardiac surgery predict the incidence of 30-day postoperative major adverse cardiac events?
Odds Ratio: 3.15 (95% CI 2.92–3.39)
Absolute Event Rate: 2.12% vs 0.26%
Categorizing elective noncardiac surgeries into low, intermediate, and elevated risk based on contemporary NSQIP data effectively stratifies the risk of 30-day postoperative MACE, which can guide preoperative cardiac evaluation.
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May guide perioperative risk discussions for elevated-risk surgeries; leaves open the need for prospective validation of causality and outcomes.
Peterson et al. (2021) conducted a cohort in Elective noncardiac surgery (n=807,413). Elevated-risk noncardiac surgery vs. Low-risk noncardiac surgery was evaluated on Postoperative major adverse cardiac events (30-day all-cause mortality, myocardial infarction, or cardiac arrest) (OR 3.15, 95% CI 2.92-3.39). Elevated-risk elective noncardiac surgeries were associated with a higher risk of 30-day postoperative MACE compared to low-risk surgeries (OR 3.15; 95% CI 2.92-3.39).