Influence of cardiovascular complications on 30-day mortality after major abdominal surgery: a regional multiple-center study

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OBJECTIVE

To determine the incidence and timing of CVC after major abdominal surgery, as well as their impact on 30-day mortality.

MATERIAL AND METHODS

A prospective cohort study was conducted between January and May 2022. Data were collected in patients who underwent major abdominal surgery. The primary outcome measure was CVC defined by the consensus “Standardized Endpoints for Perioperative Healthcare Outcomes—Key Outcomes for Perioperative and Anesthesia Care” within 30 days after surgery. The secondary outcome measure was 30-day postoperative mortality.

RESULTS

The study included 403 patients, and 21 (5.2%) ones developed CVCs. Thirty-three (8.2%) patients died within 30 days after surgery, and cardiovascular death was observed in 6 (18.2%) cases. Mortality was higher in patients with postoperative CVC (28.5% vs. 7.1%). This relationship remained after risk adjustment with hazard ratio 4.15 (95% CI 3.14—5.48). We estimated absolute mortality risk reduction by 0.4 (95% CI 0.3—0.5) in the absence of all CVCs. This would provide a relative mortality risk reduction by 21.3% if all CVCs were prevented.

CONCLUSION

Under certain conditions, 1 out of 5 postoperative deaths related to CVC could be avoided. Our results provide a basis for further research.

Keywords:

surgery

cardiovascular complications

mortality

Authors:

Butyrsky A.G.

Vernadsky Crimean Federal University

ORCID: 0000-0001-5415-3756

Mikhailichenko V.Yu.

Vernadsky Crimean Federal University

ORCID: 0000-0003-4204-5912

Aliev A.S.

Simferopol Municipal Clinical Hospital No. 7

ORCID: 0000-0002-0030-8940

Bobkov O.V.

Vernadsky Crimean Federal University

Rumyantseva M.I.

Pirogov Municipal Hospital No. 1

ORCID: 0000-0002-3591-4510

Seitnebieva Z.I.

Simferopol Municipal Emergency Clinical Hospital No. 6

ORCID: 0000-0002-2232-3180

Bobkov N.O.

Vernadsky Crimean Federal University

ORCID: 0009-0002-7950-6356

Dzhanaeva A.E.

Simferopol Clinical Hospital

ORCID: 0000-0001-9535-9523

Butyrskaya I.B.

Vernadsky Crimean Federal University

ORCID: 0000-0002-4283-2572

Received:

29.03.2024

Accepted:

06.09.2024

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