Analysis Of Risk Factors For Perioperative Major Cardiac Complications In Grade 3 And 4 Non-Cardiac Surgery

Objective:To identify and explore the risk factors for perioperative major cardiac complications in patients with grade 3 and 4 non-cardiac surgery.Methods:The clinical characteristics and surgery-related indicators of non-cardiac surgery patients aged≥18 years and with surgical grades 3 and 4 admitted to Chengdu Fifth People’s Hospital from February 2018 to December 2020 were retrospectively collected,and the patients were divided into event and no-event group according to whether the major cardiac complications occurred after operation.After that univariate analysis was performed on the data of the two groups,and then the factors with statistical significance were analyzed by multivariate analysis to clarify the risk factors of major cardiac complications during the perioperative period of grade 3 and 4 non-cardiac surgery.Results:According to the inclusion criteria and the exclusion criteria,a total of 899 patients were collected,including 130(14.46%)in the event group and 669(85.54%)in the no-event group.After univariate analysis,it was found that the two groups were significantly different in age,the history of cardiac surgery,the history of ischemic heart disease,the history of heart failure,the history of hypertension,the history of COPD,the history of cerebrovascular disease,surgical grade,anesthesia method,anemia,Scr,cTnI,NT-proBNP were all statistically significant(P<0.05).After multivariate logistic regression analysis,it was found that age(OR=2.387),the history of ischemic heart disease(OR=2.172),the history of heart failure(OR=9.435),the history of arrhythmia(OR=2.294),the history of hypertension(OR=1.796),the history of COPD(OR=2.565),the history of cerebrovascular disease(OR=2.452),higher surgical grade(OR=1.849),general anesthesia(OR=3.743),Scr>2mg/dL(OR=10.347),cTnI≥0.2ng/mL(OR=3.705),NT-proBNP>201pg/mL(OR=6.317)were not independent risk factors for major cardiac complications after cardiac surgery(P<0.05).Conclusions:The incidence of perioperative major cardiac complicatios in grade 3 and 4 non-cardiac surgery was 14.46%,and the risk factors for perioperative major cardiac complications in grade 3 and 4 non-cardiac surgery were the history of ischemic heart disease,the history of heart faure,the history ofarrhythmia,the history of hypertension,the history of COPD,the history ofcerebrovascular disease,the higher surgical grade,general anesthesia,aged≥68,Scr>2mg/dL,cTnI≥0.2ng/mL,NT-proBNP>201pg/mL.In the clinical practice,the above risk factors should be focused on,and the preoperative evaluation and perioperative management should be strengthened,so as to reduce the occurrence of major perioperative cardiac complications.