Analysis Of The Influencing Factors Of Adverse Cardiovascular Events In Non-heart Diseases After Laparotomy

Objective To investigate the influencing factors of major adverse cardiovascular events?MACE?after laparotomy in non-heart diseases.Methods Retrospective analysis was performed on the clinical data of 317 cases of non-heart diseases with laparotomy.The patients were divided into MACE group and non-MACE group according to whether MACE occurred after surgery.Univariate and multivariate Logistic linear regression methods were used to analyze the influencing factors of recent MACE occurrence.Results MACE occurred in 17 of the 317 patients,with an incidence of 5.36%.Compared with the non-MACE group,the MACE group age?t=-3.176,P=0.002?were significantly increased.While preoperative HDL-C?t=4.527,P=0.000??preoperative ALB?t=2.647,P=0.009??preoperative HB?t=2.159,P=0.032??preoperative BMI?t=3.102,P=0.002?,preoperative lymphocyte count?t=1.979,P=0.049?,and preoperative HDL-/TC?t=4.964,P=0.000?levels were significantly decreased?all P<0.05?.After collinearity diagnosis,the multicollinearity statistics of the independent variables are all less than 5,and there is no collinearity among the independent variables.By drawing THE ROC curve,the cut-off value?cut-off?was determined by using the Yoden index method:age:68year old;BMI:23.39 kg/m2;ALB:29.93g/L;HB:77.5g/L;HDL-C:3.015mmol/L;Lymph#:2.3*10^9/L;HDL-C/TC:78.13%,And assign it as an independent variable?Multivariate Logistic analysis showed that?68years old?OR=3.880,P=0.036?was an independent risk factor for the recent MACE occurrence in non-heart disease patients after laparotomy,and HDL-/TC?0.7813?OR=0.159,P=0.034?and HB?77.5g/L?OR=0.188,P=0.013?were protective factors for the recent MACE occurrence in non-heart disease patients after laparotomy?OR=0.1?3.8,all P<0.05?.The multivariate Logistic regression prediction model is P=1/(1+e^{-?-0.416+1.356X1-0.351X2-0.723X3-1.362X4-1.413X5-1.669X6-1.739X7?})?The specificity?75.33%?,sensitivity?82.35%?and accuracy?75.71%?were used to predict major adverse cardiovascular events after open surgery.Conclusion:1.The occurrence of MACE in non-heart disease patients after laparotomy is affected by factors like age,HDL-C/TC,HB,ALB?BMI and HDL-/TC.2.Multivariate Logistic analysis showed that?68 years old?OR=3.880,P=0.036?was an independent risk factor for the recent MACE occurrence in non-heart disease patients after laparotomy.Preoperative HB?77.5g/L and HDL-C/TC?78.13%were protective factors for postoperative MACE in patients undergoing open surgery.3.The established Logistic regression model can better judge the major adverse cardiovascular events after operation.The specificity?75.33%?,sensitivity?82.35%?and accuracy?75.71%?were used to predict major adverse cardiovascular events after open surgery.Intervention and treatment can be conducted according to the risk factors of patients to reduce the incidence of MACE in such patients and improve the prognosis.