Síndrome coronario agudo sintomático en el seguimiento de una cohorte en el postoperatorio de cirugía no cardiaca

Translated title of the contribution: Symptomatic acute coronary syndrome in a cohort of patients followed after noncardiac surgery

S. Gil Trujillo, A. León, R. Villazala, Francisco Pascual-Ramirez, A. Yuste, F. González, L. Collar

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objetives To determine the incidence of acute coronary syndrome (ACS) with and without ST-segment elevation, factors related to the development of ACS, mean hospital stay, and attributable mortality. Material and methods In a noncardiac surgery cohort attended in the postoperative critical care unit of Hospital General de la Ciudad Real, Spain, data were recorded prospectively between April 2006 and December 2009. The incidence of symptomatic ACS was calculated. Results Thirty-two of 1919 patients developed ACS (incidence, 1.7%). Patient factors related to developing the syndrome were male sex (P =.046), age (P =.001), arterial hypertension (68.8%, P =.012), and a history of ischemic heart disease (34.4%, P =.001). Types of surgery that were significantly related to developing ACS were general surgery (37.5%), orthopedic or trauma surgery (28.1%), and vascular surgery (15.6%) (P <.004). Twenty percent of the cohort received transfusions; 50% of those who developed ACS were transfused (P =.001). The condition was treated medically in 87.5% of the cases. The mean (SD) duration of hospital stay was 2.96 (6.3) days for the cohort and 3.88 (5) days for patients who developed ACS (P =.39); mortality rates were 5% and 6%, respectively (P =.45). Multivariate analysis confirmed that the following independent variables were associated with developing postoperative ACS: a history of ischemic heart disease (odds ratio [OR], 4.59; 95% confidence interval [CI], 1.98–10.62) and intraoperative bleeding (OR, 3.18; 95% CI, 1.51–6.71). Gynecologic surgery patients were the least likely to develop postoperative ACS (OR, 0.063; 95% CI, 0.004–1.09). Conclusions The incidence of postoperative ACS in this noncardiac surgery cohort was 1.7%. Age, male sex, a history of arterial hypertension or ischemic heart disease, type of surgery, and intraoperative bleeding requiring transfusion of packed red blood cells are factors that are associated with developing this complication. Given the seriousness of ACS it is important to classify patients by risk before surgery.

Original languageSpanish
Pages (from-to)556-562
Number of pages7
JournalRevista Espanola de Anestesiologia y Reanimacion
Volume58
Issue number9
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

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Acute Coronary Syndrome
Myocardial Ischemia
Odds Ratio
Incidence
Confidence Intervals
Length of Stay
Hemorrhage
Hypertension
Erythrocyte Transfusion
Gynecologic Surgical Procedures
Hospital Units
Mortality
Postoperative Care
Critical Care
General Hospitals
Spain
Thoracic Surgery
Orthopedics
Blood Vessels
Multivariate Analysis

Keywords

  • Acute coronary syndrome
  • Arterial hypertension
  • Ischemic heart disease
  • Non-ST-segment elevation acute coronary syndrome
  • Postoperative care

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

Síndrome coronario agudo sintomático en el seguimiento de una cohorte en el postoperatorio de cirugía no cardiaca. / Gil Trujillo, S.; León, A.; Villazala, R.; Pascual-Ramirez, Francisco; Yuste, A.; González, F.; Collar, L.

In: Revista Espanola de Anestesiologia y Reanimacion, Vol. 58, No. 9, 01.01.2011, p. 556-562.

Research output: Contribution to journalArticle

Gil Trujillo, S. ; León, A. ; Villazala, R. ; Pascual-Ramirez, Francisco ; Yuste, A. ; González, F. ; Collar, L. / Síndrome coronario agudo sintomático en el seguimiento de una cohorte en el postoperatorio de cirugía no cardiaca. In: Revista Espanola de Anestesiologia y Reanimacion. 2011 ; Vol. 58, No. 9. pp. 556-562.
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title = "S{\'i}ndrome coronario agudo sintom{\'a}tico en el seguimiento de una cohorte en el postoperatorio de cirug{\'i}a no cardiaca",
abstract = "Objetives To determine the incidence of acute coronary syndrome (ACS) with and without ST-segment elevation, factors related to the development of ACS, mean hospital stay, and attributable mortality. Material and methods In a noncardiac surgery cohort attended in the postoperative critical care unit of Hospital General de la Ciudad Real, Spain, data were recorded prospectively between April 2006 and December 2009. The incidence of symptomatic ACS was calculated. Results Thirty-two of 1919 patients developed ACS (incidence, 1.7{\%}). Patient factors related to developing the syndrome were male sex (P =.046), age (P =.001), arterial hypertension (68.8{\%}, P =.012), and a history of ischemic heart disease (34.4{\%}, P =.001). Types of surgery that were significantly related to developing ACS were general surgery (37.5{\%}), orthopedic or trauma surgery (28.1{\%}), and vascular surgery (15.6{\%}) (P <.004). Twenty percent of the cohort received transfusions; 50{\%} of those who developed ACS were transfused (P =.001). The condition was treated medically in 87.5{\%} of the cases. The mean (SD) duration of hospital stay was 2.96 (6.3) days for the cohort and 3.88 (5) days for patients who developed ACS (P =.39); mortality rates were 5{\%} and 6{\%}, respectively (P =.45). Multivariate analysis confirmed that the following independent variables were associated with developing postoperative ACS: a history of ischemic heart disease (odds ratio [OR], 4.59; 95{\%} confidence interval [CI], 1.98–10.62) and intraoperative bleeding (OR, 3.18; 95{\%} CI, 1.51–6.71). Gynecologic surgery patients were the least likely to develop postoperative ACS (OR, 0.063; 95{\%} CI, 0.004–1.09). Conclusions The incidence of postoperative ACS in this noncardiac surgery cohort was 1.7{\%}. Age, male sex, a history of arterial hypertension or ischemic heart disease, type of surgery, and intraoperative bleeding requiring transfusion of packed red blood cells are factors that are associated with developing this complication. Given the seriousness of ACS it is important to classify patients by risk before surgery.",
keywords = "Acute coronary syndrome, Arterial hypertension, Ischemic heart disease, Non-ST-segment elevation acute coronary syndrome, Postoperative care",
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T1 - Síndrome coronario agudo sintomático en el seguimiento de una cohorte en el postoperatorio de cirugía no cardiaca

AU - Gil Trujillo, S.

AU - León, A.

AU - Villazala, R.

AU - Pascual-Ramirez, Francisco

AU - Yuste, A.

AU - González, F.

AU - Collar, L.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Objetives To determine the incidence of acute coronary syndrome (ACS) with and without ST-segment elevation, factors related to the development of ACS, mean hospital stay, and attributable mortality. Material and methods In a noncardiac surgery cohort attended in the postoperative critical care unit of Hospital General de la Ciudad Real, Spain, data were recorded prospectively between April 2006 and December 2009. The incidence of symptomatic ACS was calculated. Results Thirty-two of 1919 patients developed ACS (incidence, 1.7%). Patient factors related to developing the syndrome were male sex (P =.046), age (P =.001), arterial hypertension (68.8%, P =.012), and a history of ischemic heart disease (34.4%, P =.001). Types of surgery that were significantly related to developing ACS were general surgery (37.5%), orthopedic or trauma surgery (28.1%), and vascular surgery (15.6%) (P <.004). Twenty percent of the cohort received transfusions; 50% of those who developed ACS were transfused (P =.001). The condition was treated medically in 87.5% of the cases. The mean (SD) duration of hospital stay was 2.96 (6.3) days for the cohort and 3.88 (5) days for patients who developed ACS (P =.39); mortality rates were 5% and 6%, respectively (P =.45). Multivariate analysis confirmed that the following independent variables were associated with developing postoperative ACS: a history of ischemic heart disease (odds ratio [OR], 4.59; 95% confidence interval [CI], 1.98–10.62) and intraoperative bleeding (OR, 3.18; 95% CI, 1.51–6.71). Gynecologic surgery patients were the least likely to develop postoperative ACS (OR, 0.063; 95% CI, 0.004–1.09). Conclusions The incidence of postoperative ACS in this noncardiac surgery cohort was 1.7%. Age, male sex, a history of arterial hypertension or ischemic heart disease, type of surgery, and intraoperative bleeding requiring transfusion of packed red blood cells are factors that are associated with developing this complication. Given the seriousness of ACS it is important to classify patients by risk before surgery.

AB - Objetives To determine the incidence of acute coronary syndrome (ACS) with and without ST-segment elevation, factors related to the development of ACS, mean hospital stay, and attributable mortality. Material and methods In a noncardiac surgery cohort attended in the postoperative critical care unit of Hospital General de la Ciudad Real, Spain, data were recorded prospectively between April 2006 and December 2009. The incidence of symptomatic ACS was calculated. Results Thirty-two of 1919 patients developed ACS (incidence, 1.7%). Patient factors related to developing the syndrome were male sex (P =.046), age (P =.001), arterial hypertension (68.8%, P =.012), and a history of ischemic heart disease (34.4%, P =.001). Types of surgery that were significantly related to developing ACS were general surgery (37.5%), orthopedic or trauma surgery (28.1%), and vascular surgery (15.6%) (P <.004). Twenty percent of the cohort received transfusions; 50% of those who developed ACS were transfused (P =.001). The condition was treated medically in 87.5% of the cases. The mean (SD) duration of hospital stay was 2.96 (6.3) days for the cohort and 3.88 (5) days for patients who developed ACS (P =.39); mortality rates were 5% and 6%, respectively (P =.45). Multivariate analysis confirmed that the following independent variables were associated with developing postoperative ACS: a history of ischemic heart disease (odds ratio [OR], 4.59; 95% confidence interval [CI], 1.98–10.62) and intraoperative bleeding (OR, 3.18; 95% CI, 1.51–6.71). Gynecologic surgery patients were the least likely to develop postoperative ACS (OR, 0.063; 95% CI, 0.004–1.09). Conclusions The incidence of postoperative ACS in this noncardiac surgery cohort was 1.7%. Age, male sex, a history of arterial hypertension or ischemic heart disease, type of surgery, and intraoperative bleeding requiring transfusion of packed red blood cells are factors that are associated with developing this complication. Given the seriousness of ACS it is important to classify patients by risk before surgery.

KW - Acute coronary syndrome

KW - Arterial hypertension

KW - Ischemic heart disease

KW - Non-ST-segment elevation acute coronary syndrome

KW - Postoperative care

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