Key result
Esophageal cancer surgery was associated with the highest risk of perioperative major adverse cardiovascular and cerebrovascular events (OR 7.89) among patients undergoing major cancer surgeries.
Why the study?
Major adverse cardiovascular and cerebrovascular events are an important cause of perioperative morbidity and mortality, but national trends and cancer types associated with high rates during major cancer surgeries required investigation.
Observational (n=2,854,810)
Yes
Perioperative MACCE occurs in 2.4% of major cancer surgeries, with the highest risks in esophageal, lung, and pancreatic surgeries, though overall rates of MACCE have significantly declined from 2005 to 2014.
Retrospective NIS data link perioperative MACCE to specific cancer surgeries; leaves open need for prospective risk-stratification trials.
Major adverse cardiovascular and cerebrovascular events (MACCE) is an important cause of morbidity and mortality during perioperative period. In this study, we looked for national trends in perioperative MACCE and its components as well as cancer types associated with high rates of perioperative MACCE during major cancer surgeries. This study was a retrospective analysis of the National Inpatient Sample, 2005-2014. Hospitalizations for surgeries of prostate, bladder, esophagus, pancreas, lung, liver, colorectal, and breast among patients 40 years and greater were included in the analysis. MACCE was defined as a composite measure that included in-hospital all-cause mortality, acute myocardial infarction (AMI), and ischemic stroke. A total of 2,854,810 hospitalizations for major surgeries were included in this study. Of these, 67,316 (2.4%) had perioperative MACCE. Trends of perioperative MACCE showed that it decreased significantly for AMI, death and any MACCE, while stroke did not significantly change during the study period. Logistic regression analysis for perioperative MACCE by cancer types showed that surgeries for esophagus, pancreas, lung, liver, and colorectal cancers had significantly greater odds for perioperative MACCE. The surgeries identified to have greater risks for MACCE in this study could be risk stratified for better informed decision-making and management.
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Ramamoorthy et al. (2023) conducted an observational in Major cancer (n=2,854,810). Esophageal cancer surgery vs. Other major cancer surgeries was evaluated on Perioperative MACCE (in-hospital all-cause mortality, acute myocardial infarction, and ischemic stroke) (OR 7.89, 95% CI 6.88-9.04). Esophageal cancer surgery was associated with the highest risk of perioperative major adverse cardiovascular and cerebrovascular events (OR 7.89) among patients undergoing major cancer surgeries.
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