Key result
Major cancer surgeries carry a ~2.4% perioperative MACCE risk, with overall rates declining over time.
Why the study?
Major adverse cardiovascular and cerebrovascular events are a major 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 decreasing trends over time but higher risks associated with specific cancer types such as esophagus, pancreas, lung, liver, and colorectal.
Perioperative MACCE risk stratification by cancer type may guide counseling; extends observational data but leaves open whether interventions improve outcomes.
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, 67316 (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. (2022) conducted an observational in Cancer (n=2,854,810). Major cancer surgeries was evaluated on Perioperative MACCE (composite of in-hospital all-cause mortality, acute myocardial infarction, and ischemic stroke). Among 2.8 million patients undergoing major cancer surgeries, the overall prevalence of perioperative MACCE was 2.4%, with rates decreasing significantly from 2005 to 2014, though surgeries for esophageal, pancreatic, lung, liver, and colorectal cancers carried significantly higher risks.
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