Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause mortality. We performed a prospective, international cohort study between January 2022 and May 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries across Europe. The primary outcome measure was cardiovascular complications as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care initiative up to 30 days after surgery. The secondary outcome was 30-day postoperative mortality. This study included 24,203 patients, of whom 611 (2.5%) developed cardiovascular complications. In total, 458 (1.9%) patients died within 30 days of surgery, of which 123 (26.9%) deaths were judged to be cardiac-related. Mortality rates were higher in patients who developed postoperative cardiovascular complications than in those who did not (19.8% vs. 1.4%), which persisted after risk adjustment (hazard ratio (95%CI) 4.15 (3.14-5.48)). We estimated an absolute risk reduction (95%CI) of 0.4 (0.3-0.5) in mortality in the absence of all cardiovascular complications. This would confer a relative risk reduction in mortality of 21.1% if all cardiovascular complications were prevented. Postoperative cardiovascular complications are relatively common and occur early after major abdominal surgery. However, over 1 in 5 postoperative deaths were attributable to these complications, highlighting an important area for future randomised trials.
Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study / Porcu, Alberto; Perra, Teresa; Madonia, M; Scognamillo, F; Tilocca, Pl; Delogu, D; Scanu, A; Fancellu, A; Feo, C; Cossu, Ml; Ginesu, Gc; Dessole, S; Capobianco, G; Petrillo, M; Dessole, ; Fo, Kouli; D, Chaudhry; Szy, Ooi; S, Q Shafi; I, Jakaityte; A, M Riad; M, Kawka; M, Steinruecke; L, Ko; R, R Gujjuri; K, El-Boghdadly; J, Martin; B, M Biccard; A, Bhangu; J, C Glasbey; S, Moug; T, Pinkney; T, Richards; A, Docherty; M, Chew; E, M Harrison; K, A McLean; S, K Kamarajah; R, Blanco-Colino; N, Brindl; S, Brown; W, A Cambridge; K, Gressmann; A, Hilder; A, Jaffer; E, Matey; A, Mergo; E, C Mills; V, Murray; I, S Pereira; A, Sgrò; I, Trout; A, Turňa; C, Varghese; W, Xu; M, Phull; R, Mouton; N, Smart; I, Dajti; M de, Cillia; G Van, Ramshorst; S, Delibegovic; H, Mughal; J, Mihanovic; N, Gouvas; P, Kocian; V, Levesen; J, Kaupilla; D, Merz; M, Joos; A, Ioannidis; 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S Busto, Suarez; C De La Infiesta, García; O, Arencibia; D Gonzalez, Garcia-Cano; M, Laseca; A Martin, Martinez; J, A Guijarro Guedes; A, F Rave Ramirez; Y Gil, Gonzalez; A, M Hernández Socorro; D Ponce, Arrocha; A Cruz, García; C Mendoza, Rodriguez; E, Catala; C, S Romero Garcia; A García, Trueba; V, Georgieva; A, I Hernández Álvarez; C, Martinez-Perez; E De, Valera; J, J Gascón; E Lopez, Alcina; L Samper, Monton; K, Aghababyan; A Valero, Tarin; C Salinas, Lozano; A, Cervera; J, C Catalá Bauset; B, Ramia; F Marques, Peiro; J De, Andres; S, P Iserte Juan; M Peñalver, Gaspar; J, Gilabert-Estellés; M De La, Rosa-Estadella; A, Fernandez-Colorado; M, Serrano-Martin; A, Gasulla-Rodriguez; M, Juarez-Pomes; M, E Ossola; G Sanz, Ortega; J, Gómez; M Del, Campo; R, Corrochano; M Galan, Hernandez; F, J Molano Nogueira; L Ibañez, Vazquez; J, Dziakova; A Zarza, Martín; S, Infante; D, Moro-Valdezate; L Pérez, Santiago; A, I Molina; A Vinuesa, Huesca; R Gadea, Mateo; L, Navarro-Sanchis; P, Aracil-Boigues; C, Jezieniecki; B De, Andrés-Asenjo; Á Zamora, Horcajada; F Natal, Álvarez; L, A Cuellar Martin; M, Montes-Manrique; G, Cabezudo; T Gómez, Sanz; A Herranz, Arriero; N, Sierrasesumaga; M, Rodriguez-Lopez; M Ruiz, Soriano; A Sánchez, Gollarte; A, M Minaya Bravo; C Guijarro, Moreno; A, Galvan; E, González; M, Á García Ureña; A Robin Valle De, Lersundi; J, Ruiz-Tovar; A López, Campillo; M Jimenez, Toscano; S, Salvans; S, M Jaume Böttcher; À, Godó; G Busquet, Raich; C, Téllez; J, A Sánchez García; M Ribas, Ardanuy; P, Saavedra; A Sánchez, Cabrero; J, Clivillé-Pérez; M Durante, Escutia; A Rabasa, Rodríguez; P, Aguilera; C Giménez, Francés; M, Ruiz-Marín; D García, Escudero; M Valero, Soriano; M Ramirez, Faraco; S Galán, Jiménez; P Alcón, Cerro; J, M Rodríguez Lucas; M Carrasco, Prats; E Peña, Ros; Mdp López, Sánchez; V, J García Porcel; M, Tamayo; J, M Muñoz Camarena; R Albarracin, Garcia; O, Molina; P Moreno, Sánchez; I, Jiménez; P Pastor, Perez; M, B Agea Jiménez; D Candela, Mas; M Artés, Artés; J, A Benavides Buleje; F, M González Valverde; P, López-Morales; A, Sanchez; E, R Bobadilla Romero; M, Allue; L, Ponchietti; R Latorre, Tomey; D Torres, Ramos; L, M Jimenez-Gomez; S Valdés, López-Linares; Y, T Moreno Salazar; J Soto, Galán; C Moreno De, Alboran; A, Prosperi; J, J Osma; A, Blanco; M Sánchez, Rodríguez; E, Valdivielso; Á, Cejudo; C Perez, Carpio; F Vasques Seabra, Águas; E Sánchez, Martín; S, Pérez-Ajates; E, Macarulla; A Álvarez, Torrado; C, Galmés; M, Artigot; J Marin, Garcia; J, R Oliver Guillen; A López De, Fernández; B, F Fernández-Velilla San-José; D Ambrona, Zafra; S Pérez, Farré; J Ortega, Alcaide; L Codina, Corrons; E Sisó, Soler; F, D Gómez Báez; G, López-Soler; E Gutiérrez, Pérez; S Aix, Molina; M, Vallve-Bernal; A Varona, Mancilla; Á, M Aldama Martín; R, Casanova; L, Sevillano; J, J Muela; M Rodrigo, Rodrigo; I, Goujon; C Fructuoso, Iniesta; S, Pérez-Bertólez; E, Monclus; L, Fernández; M, G Silva Hernández; F, Vicario; P Garcia, Pimentel; R García, Álvarez; N Bouzó, Molina; Á, Ramiro; Z, A Calderon Barajas; R, Sanz; Z, Xia; P, Rodríguez; C Sarrais, Polo; A Martínez, López; C, Estrada; P, E Gómez De Castro; D Fernández, Martínez; L, J García Flórez; I De Santiago, Alvarez; L García, Alonso; G, García-Santos; L, A García González; B, Carrasco; D, W Silva-Cano; P Del Val, Ruiz; G Martínez, Izquierdo; A, Corteguera; J, Iturbe; E López-Negrete, Cueto; A, Cembellin; C Ramos, Montes; G, P Ibero Casadiego; M, Prieto; I Villalabeitia, Ateca; T Pascual, Vicente; B Villota, Tamayo; A, Perfecto; S, Mambrilla; I, L Ramos Del Moral; V Jiménez, Carneros; P, Pastor-Riquelme; A Franco, Lozano; L, Alonso-Lamberti; M, Lozano; J, García-Quijada; R, Zhang; A, García; M, M Martín; M Yeh, Ahumada; A Carreño, Pallarés; Á Pérez, Rubio; R, E Goran; N Gómez, Diez; G Zomeño, Bravo; J, C Bernal-Sprekelsen; G, S Martínez Fernández; R Marquina, González; C, Toribio-Vazquez; A, Eguibar; H, Perez-Chrzanowska; P Serrano, Méndez; S Valderrabano, Gonzalez; F, J Reinoso; A, Yebes; M, B Alonso Bartolomé; H, R Ayllón Blanco; I, Cristóbal; I, Pellicer; R Arenal, González; J, D Zafra Angulo; V Duque, Mallén; C, Gracia-Roche; I Gascon, Ferrer; D, Aparicio-López; M, Antonio; M Herrero, Lopez; S, Saudí-Moro; M, Á Gascón Domínguez; T Gimenez, Maurel; B, Matías-García; N Morales, Palacios; M Diez, Alonso; A, Gutiérrez; S Soto, Schütte; M, Bru-Aparicio; R Jiménez, Martín; A Sanchez, Pellejero; S Vázquez, Valdés; C Vera, Mansilla; A, Quiroga; F, Mendoza-Moreno; L Diego, García; E Serrano, Yébenes; F Mañes, Jiménez; I, Lasa; E Ovejero, Merino; L, Casalduero; Y, Allaoua; A Blazquez, Martin; D Córdova, García; R Alvarado, Hurtado; P Laguna, Hernández; F Garcia-Moreno, Nisa; H, Juara; C, Aldecoa; F, J Tejero-Pintor; M, García; E Aguado, Saster; E Ruiz De, Santos; A, D Bueno Cañones; S Pérez, Fernández; M, G Alija Garcia; R, Urruchi; R Rioja, Garrido; M, Madrid; A, Bordell; I Arranz, Chamorro; P Rodriguez, Cañal; D Pacheco, Sánchez; P, Marcos-Santos; S Veleda, Belanche; J, L Maestro De Castro; M, J Blanco García; E Laita, Jiménez; L, Leal; L Vaquero, Perez; C, Barbosa; M Ramos, Carrasco; I, Garcia-Saiz; P, Rodicio; F Acebes, García; A, Lizarralde; A Sanchez, Diez; E, Ferrer-Inaebnit; J, J Segura-Sampedro; M Alfonso, Garcia; Ggc, Gutiérrez-Cañadas; A, Oseira; N Torres, Marí; J, Loyola; B, Villalonga; P, Camporro; N, Pagès; E, Colás-Ruiz; J, A Cifuentes Rodenas; M Castro, Suárez; R, Moll-Amengual; J, Mata; J Fernández, Manzano; B Gómez, Pérez; J Gil, Martínez; Á Cerezuela Fernández De, Palencia; A Aliaga, Rodriguez; P Gómez, Valles; A Delegido, García; E Gil, Gómez; M, J Montoya; A, Navarro-Barrios; V, Cayuela; J, J Ruiz Manzanera; M, I Jiménez Mascuñán; A, I Gutiérrez Fernández; I Sánchez, Esquer; P, J Gil Vázquez; D, Ferreras; A Balaguer, Román; F, Gómez-Bosch; F, Alconchel; A, Romero; V, M Durán Muñoz-Cruzado; C, J García Sánchez; A Tejero, Rosado; B, Ruiz; Mdc, Roman; J, J Rubio Fernández; Á De, Jesús; M Ostos, Diaz; C, Quintero-Pérez; A Sánchez, Marín; M Alvarez, Aguilera; M Leal, Mérida; I, Ager; J, Sancho-Muriel; M, Frasson; B, Castro; P, Guerrero; M, Nieto-Sanchez; Q, Cruz; H, Cholewa; L, Hurtado-Pardo; D, Plazas; M, Serrano-Navidad; J, Castillo; R, Ballestero; V Valbuena, Jabares; C, García; N Garcia, Formoso; E Herrero, Blanco; N Suarez, Pazos; C Cagigas, Fernandez; M Gomez, Ruiz; Y, T Benic Yoris; M, Merayo; M, E Gonzalez Fernandez; S Alonso, Batanero; J Rodríguez, Gómez; A, Landaluce-Olavarria; B, Estraviz; I, Markinez; D, Gómez; L Fernández Gómez, Cruzado; M González De, Miguel; J, M De Francisco Rios; A, Urigüen; A Gómez Del, Pulgar; E, Espin-Basany; A, Gil-Moreno; S, Bellmunt-Montoya; C, Dopazo; S, González-Suárez; P Olid, Mayoral; M González, Antúnez; E Del Barco, Martínez; Y Bejar, Dolcet; D, Gil-Sala; C Marrero Eligio De La, Puente; L Sánchez, Besalduch; M Barrio, Zaragoza; J, F Lopez Lozano; C, Olaria; S Catalan, Sanz; E De, Ciria; L Segura, Farran; N, Montes; J, M Zanca Gómez; I Puig, Escobar; M Armengol, Alsina; M San, Nicolas; M, Escura; M, Sánchez; M Rivas, Agudo; L, Aalouf; D Maya, Salas; L Hernando, Marín; N Umpiérrez, Mayor; J, L Sanchez Iglesias; Y Fernández, Henriquez; I Feixa, Molina; M, J Gomez-Jurado; V, Bebia; M, Racine; M, Sauvain; A, Mujcinovic; D, Bolla; Y, Dimitrov; N, Arenja; J, N Marx; M, Kalisvaart; C, Andreou; P, Brandts; U, Pfefferkorn; L, Eisner; U, Dietz; J, Gass; J, Metzger; A, Scheiwiller; V, Kremo; D, Gero; M, Bueter; F, M; R, Schulz; F, Mongelli; I, Soave; D La, Regina; C, Canonica; F, Sabbatini; P, Gaffuri; S, Spampatti; C, Santarelli; M Di, Giuseppe; M, Marengo; S, Passoni; G, Dellaferrera; D, Provenzi; L, Bernardi; A, Cristaudi; P, Aurora; S, G Popeskou; P, Christian; M, Antonilli; F, A Scalvi; V, Sevas; G, Palumbo; L, Maoloni; C, Cencetti; G, Pagnani; M, Hitz; J, Dürmüller; S, Däster; G, F Hess; Nle, Aegerter; P, Sedlaczek; S, Soysal; J, Zeindler; F, Angehrn; L, Müller; S, Taha-Mehlitz; F, Haak; F, Nocera; T, Karli; I, Lazaridis; A, Tampakis; A, Lalos; U, Friedrich; B, Wiesler; N, Varathan; R, Frey; G, K Kurtoglu; A, Aghayeva; C, Turam; G, M Kurtoglu; M, Maarouf; B, Baca; S, D Ilhan; Y, O Koyluoglu; M, E Seker; M, Ulufi; M, Erkaya; Fdb, Kılıçkan; S, Bayrakceken; B, B Ozmen; B, Togay; M, Doğan; T, Çetinkaya; E, Tuzuner; T, Karahasanoğlu; I, E Yavuz; I, A Bilgin; S, S Kekik; E, Dönmez; M, Dikeç; N, Ramoğlu; N, Yurtseven; O, Takmaz; Ö, Orhun; N, Karadeniz; O, Saylık; E, M Uğur; E, Ada; A, Durbas; I, Hamzaoglu; K, Uzun; M, Gungor; I, Y Gebedek; E, Ç Hayırlıoğlu; M, Halıcı; G, O Ceyhan; E, Aytac; M, Gulmez; E, Capkinoglu; T, U Yilmaz; A, Ozer; S, Keçeoğlu; Z, C Eraslan; V, Ozben; O, Dülgeroğlu; C, Saraçoğlu; M, Erkan; C, Uras; H, D Copur; N, U Dogan; E, Topal; I, Demirsoy; D, Korkmaz; U, Can; D, Buğra; E, Sobutay; H, Çakıt; E, Ergün; S, Zenger; C, Bilgic; B, Gurbuz; K, Sünter; I, Gecim; S, Sefer; B, Inceöz; M, B Genc; A, K Uygun; E, Yücel; A, Barcin; Y, Altinel; Y, E Aktimur; S, Meriç; K, Özdoğan; A, I Sayar; A, G Durmaz; I, Çakır; E, S Ünlü; G, Kiran; A, Dal; E, Ozkan; S, Kalkan; M, M Öncel; Ç, Çetin; G, Yılmaz; H, Karimi; Y, Iskurt; E, Yardimci; M, Eker; A, O Balkan; H, B Gönül; E, Herdan; M, Ertugrul; T, Takmaz; S, S Kilinç; M, S Pinar; F, Yıldıztekin; E, C Coşkun; I, Olgun; G, Ince; O, Isik; M, Şen; R, Özata; B, Eroğlu; B, Büyükpolat; G, Ishakoğlu; D, Özen; M, O Aktaş; B, Kılıç; T, Yılmazlar; M, S Koçbey; N, Işıklı; R, G Yıldız; T, Baghirov; E, Uygun; M, Yugaç; E, Keskin; B, E Bozkurt; S, Tas; Ö, Ö Türkmen; B, Ata; B, Alan; N, Işık; T, Göver; T, Bisgin; E, Özalp; S, Sökmen; B, Manoğlu; C, Bakar; O, Bozbiyik; U, Zorlu; N, N Zengin; E, S Akbulut; S, Tunali; B, Kutlu; Y, A Oğuz; B, Küçükateş; E, Yildiz; A, N Sakmar; T, Yoldas; Z, E Akgün; M, A Korkut; C, Çalışkan; E, Aksit; E, F Aksalman; A, O Koçoğlu; F, Basci; B, Yigit; O, Ilhan; R, K Liman; M, Uzun; I, Ağaçkıran; C, Şahin; S, Leventoğlu; Ö, Kubat; I, Genç; A, Oyanik; F, I Gurbuzer; N, Satilmis; S, Cam; M, Ekinci; M, Gönül; D, Chasan; Sgf, Zara; Ş, Sök; A, Yalcinkaya; E, T Acıpınar; U, Timurçin; N, B Afzal; Sha, Gillani; S, Gillani; S, Yazıcı; 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M, Moran; B, Celik; E, Sivrikoz; K, Karabulut; A, C Dural; T, Ikizoğlu; H, Aydede; T, Yalçın; A, Dalkıran; H, B Yapici; T, K Uprak; Y, Tatar; Y, Aksahin; C, Aral; S, Z Cetin; D, Artvin; Z, Tatar; I, S Karakuş; S, Çatal; B, Nalbantoğlu; S, Bettar; Z, Düzyol; B, C Demir; M, F Kırcalı; M, E Taşcı; F, Secil; E, N Akkaya; I, Kayılıoğlu; B, Hekmatjou; A, Çağlayan; M, A Dadaşoğlu; C, Fergar; M, S Beden; E, Kayhan; I, Arslan; G, Z Koçyiğit; B, Beyoğlu; C, Varan; U, Sungurtekin; H, Sungurtekin; U, Özgen; B, Çetin; A, Pergel; M, Uyan; E, Erata; E, Aldhahebi; B, Aslan; Ş, Kabalı; F, Köse; I, Keşaplı; U, C Dulger; F, Altintoprak; M, Akçay; E, S Cünük; M, B Kamburoğlu; I, F Küçük; M, Yigit; E, Sabuncu; A, T Harmantepe; B, U Aka; E, Baş; T Yavuz, Akça; A, C Sarı; E, Colak; M, Candan; M, E Kara; A, B Ciftci; K, Yemez; M, S Uyanik; S, Polat; G, O Kucuk; S, Ocak; Y, Tosun; E, Unal; C, B Ofluoğlu; C, Üstbaş; Ö, Gangal; A, N Sanli; S, Sayır; C, Karslioglu; I, Ulusoy; A, E Tufan; U, Demir; M, F Celayir; E, Baran; A, B Aksoy; D, B Fırat; A, Yüksel; O, Güven; I, Ertaş; Z, S Kuzu; H, M Köksal; M, Gok; M, N Görgün; P, Yazici; S, Ömeroğlu; B, B Özdemir; E Kabul, Gürbulak; M, Ajredini; I, E Cakcak; I, H Atakan; A, Göztepe; O, Budak; E, O Aydoğdu; E, Erdem; C, Yılmaz; J, Özdemir; D, Alkan; E, Cengiz; C, N Donmez; E, Akyüz; Y, H Ergun; M, G Ozer; Ç, Ak; F, Bolat; E, Kasapoğlu; A, Tatlisu; Y, Yorulmaz; A, Enez; B, Ozkan; Z, E Yilmaz; S, N Altin; B, Gunes; B, Kaban; O, Korkmaz; I, B Demir; G, A Öz; A, B Tuluce; Z, N Turkmen; F, Yildiz; B, Kandil; A, Ulkucu; G, Kıral; D, Yavuz; Ü, C Köksoy; Z, C Kus; M, B Erten; M, Mutlu; F, Hökelekli; T, Aslan; Ş Orçan, Akbuz; E, Durmuş; T, E Gökçek; H, S Ulgur; O, F Ozkan; H, K Karakullukcu; A, Yıldız; M, Ceyhan; M, Ş Çelik; M, Kalın; E, F Kirkan; A, Demirbilek; M, N Çelik; Ö, Karbuş; S Demirli, Atici; B, Abud; H, Erdinç; K, B Ön; B, Sevinç; N, Damburacı; E, Altiner; B, Özdemir; Ö, Manisalı; G, Ural; M, K Topal; T, Can; S, Ercan; S, Kaynar; O, Emanet; M, Javadov; U, B Demir; A, Erdem; F, Demircan; M, Yelmenoğlu; E, Seçen; B, Alkışer; F, Arık; E, E Kaya; D, Akkad; D, Karaçam; U, Karacam; M, A Yücel; A, Hatipoğlu; N, Mumcu; O, Karima; M, B Dal; M, Aljobbeh; J, Montaser; M, A Kara; F, A Gultekin; O, Deniz; N, Kavak; B, Kum; M, M Ecir; Y, G Yavuzer; Z, Sezgin; U, Koçdemir; B, Yirmibeş; Ş, Atalay; A, May; S, Varna; I, Aydoğdu; A, Abdel-Fattah; G, Ramsay; M, A Bin Badekruzaman; M, Karvelyte; M, Siamisang; S, Clunie; M, Mikalauskaite; A, Nessa; C, Joshi; N, Jodeh; R, Zafar; J, Miller; R, Basharat; T, Singh; O, Weston; R, Loy; Ehc, Tsoi; A, Chandiramani; R, J Sumarlie; L, Mitchell; M, Yousif; M, Qadir; M, Gannon; Eyh, Tong; J, Tsang; M, Elmarghani; J, Kaczmarek; J, Luangboriboon; R, Mcewen; B, Tse; M, C Wong; Z, X Wong; T, Diffley; O, Jaruwattanapradid; N, Ng; L, Mchaffie; C, Wright; D, Joyce; V, May; S, Emmanuel; A, D'Costa; A, Kumar; C, Hanganu; S, Gourgiotis; A, Townson; C, Y Williams; E, Baines; L, Smith; N, Elks; N, Simon; R, Chintapalli; A, Banerjee; S, Bhogle; B, Ryan; D, Maghsoudi; E, Clifton; T, Nott; H, Vickers; G, D Stewart; Z, X Zhong; K, Ioannou; Ckh, Ne; R, Conci; E, Fitzsimons-West; X, L Ling; R, Patel; R, Sanghera; I, Dokubo; I, Seago; O, Fairhurst; B, Amin; M, Aniq; E, O'Keeffe; S, James; M, Chowaniec; L, Rutigliani; M, Hu; A, F Ferreira; M, Kalogeropoulou; G, Hui; L, Coakham; S, Healy; K, Gilanliogullari; G, Nishimura; M, Choi; R, Lunevicius; D, Aje; R, Mcnicholas; C, Newman; E, Bollen; I Ferreira, Xavier; L, G Baloch; N, A Koduah-Sarpong; G, O'Sullivan; S, Saseendran; A Bin, Sahl; E, Murphy; H, Hussain; A, Nicholls; S, O'Dolan; A, Gidwani; E, Patterson; L, Loughrey; K, Donaghy; K, Hana; M, Monaghan; S Ni, Shandair; N, Kulasingha; N, Gormley; M, Mcglinchey; E, Dunlop; B, Dunwoody; S, H Lian; S, C Jayasangaran; E, Logue; P, Goswami; P Ann, Jacob; C, O'Kane; A, S Ab Razak; K, Govender; E, J Mccann; S, Perry; S, Mckendry; A, Pachchigar; A, Singh; S, Dindyal; S, Pendyala; V, Venkateswaran; L, Alhoussan; F, Feil; T, Hughes; Y, Gerçek; M, Choudry; O, Haidar; T, Rujeedawa; T, Speirs; J, Odendaal; J, Chu; A, Shahab; S, Ranjithkumar; V Pillai Rajendra, Prasad; T, Linn; J, Clark; M, Sharma; S, Lockwood; S, Chawla; R, Deshpande; N, Long; J, Rees; M, Kobetic; D, Fawcett-Till; O, Ferris; G, Harrison; T, Hibbs; Ctw, Tsang; L, Hurley; T, Jichi; C, Badrinath; L, Applebee; K, Ecott; T, Sullivan; B, Piecha; A, Jagadish; Z, Sajjad; R, Griggs; S, Joyce; R, Spurgeon; M Ali, Khan; M, Hobrok; R, Roberts; D, Davies; P, Eaton; L, Bishop; S, Magaway; K, Denholm; S, Doyle; M, Salter; V, Chan; K, Mockford; J, Heinz; I, Ahmed; M, Coverdale; R, J McKillen; M, Maguire; N, Mclees; J, Lau; L, Mcguigan; A, O'Neill; D, O'Hare; C, Beggs; O, Owolabi; J, Hunter; J, Kinross; J, Kotecha; R, Doherty; E, Wagner; L, Hodges; H, Hassan; K, Sribaskaran; K, Pouris; S, Jain; A, J Kim; S, Gill; S, Nand; O, Toutouza; A, Joshi; L, Thornley; R, Chen; M, Ogunjimi; A, Mahmood; R, Chong; M, Yanai; D, Bae; J, Dhaliwal; A, Lovejoy; A, R Akhbari; N, Mayor; C, Kontovounisios; 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K, Aldred; P, Manokar; A, Moore; N, Mistry; J, Zgliczyńska; C, Haylett; A, Adeyanju; E, Headford; R, Khanna; M, Deef; T, Durkin; E, Trayling; R, Cowell; A, Turner; K, Noureldin; W, Down; A, Cyril; C, O'Halloran; M, Shirke; M, Epanomeritakis; A, Karnati; G, Sreejith; C, Sinton; L, Oliver; H, F Ali Azamatullah Khan; E, O'Kane; J, Trouton; B, French; I, Campbell; R, Curran; C, Brines; A, Mcdermott; N, Yang; S, Vig; S, Chowdhury; R, Valecha; R, Lau; M, Nafis; S, Thavanesan; J, Marks; L, Akaje-Macauley; N, Patel; E, Beard; A, Nanda; C, Mills; A, Cheung; J, Amalendran; L, Todd; S, Smolarek; T, Warrener; S, Sen; A, Mudehwe; S, Khan; B, Wisden; G, Lau; L, Schanzer; Z, King; K, Giridhar; M, Reed-Embleton; L, White; P, Filippidis; L, Lee-Smith; O, Carless; C, King; M, Herriott; N, Saju; Y, M Tin Maung; A, Deligianni; A, Mumtaz; H, Hill; S, Sahdev; I, Thomas; A, Shah; S, Saji; J, Hargreaves; R, Khan; A, Tharani; R, Ullah; J, Ludgate; S, Shrestha; E, Bota; A, Abdullah; Z, Patel; A, Clark; I, Suchett-Kaye; B, Stubbs; B, Holmes; A, Santaniello; T, Watkinson; A, Crimmins; M, K Gupta; S, Abraham; A, Bellringer; R, Clowes; D, Chatzopoulou; J, Eid; N, Rao; J, Caterson; F, Soggiu; H, Malik; I, Jose; K, Kavallieros; C, Rizk; B, Thummala; K, Li; A, Goel; R, Pantula; J, Toh; M, X Fu; C, C Ho; K, Vivek; E, Owen; A, Day; A, Jamieson; H, Hassani; T, Thavarajah; M, Vivekanandan; A, Muneer; M, Chauhan; D, Veeramootoo; S, Ali; J, Dosanjh; F, Newing; E, Jose; H, Chauhan; A, Kulshreshtha; E, Thomas; P, Patel; R, Chhabra; B, Sajan; S, Ragavan; R, Hariharan; I, Lam; B, Fleet; N, O'Hara; A, Wright; V, Reddy; H, Darweesh; A, Khan; S, Handa; D, Kewada; F, Rana; H, Williams; F, Bombieri; D Pestotnik, Stres; A, Menon; L, Selvam; A, Pusok; C, Street; M, Zohdy; B Aguirrezabala, Armbruster; I, Okoye; L, Potts; M, Fayyad; K, Bajaj; H, Alfa; N, Sivakumar; N, Duncan; C, Roxburgh; L, Huang; K, Lukito; X, Huang; S, Baig; C, Y Chan; R, Philip; L, Shaheen; J, Dodds; H, X Yeow; M, Devindran; Z, C Sia; J, H Park; B, Furze; 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M, Weir; A, Gibbs; A, Al-Shaye; M, Alwahid; A, Tait; S, Smith; A, Doye; K, L Law; T, G Groot-Wassink; G, Geller; K, Seebah; O, Cox; A, Shetty; Dcj, Oh; E, Lee; B, Packham; M, Aarons; K, Saadeh; J, Mui; R, Huynh; M, Eid; N, Honey; J, Kaur; R, Hand; L, Lai; C, Koubaesh; H, Maqsood-Shah; J, Suresh; L, John; C, Foster; E, Lewis-Orr; S, Reilly; A, Bhatia; K, Goves; M, Blesson; L, Purser; L, Cobb; M, H Sarker; N De, Sousa; S, Syed; N, Rajendran; J Tan Sue, Wei; G, Navakumar; V, Butnari; M, Senthilkumar; Z, Q Chew; L, Zekaite; S, Paranietharan; M, Haque; S, Balenthiran; K, J Chin; S, Ahuja; T, Moothathamby; F, Moniati; Y, Z Kong; Ejh, Lee; L, Sharma; P, Found; Y, Sivakumaar; H, Senior; N, Simeen; A, Arora; A, Chu; R, Mizori; T, Beazer; J, M Dudziak; T, Squeri; F, Weston; M, Zhou; J Van, Ross; S, Tian; J, Bedford; R, Lam; F Karami Tireh, Shabankareh; H Donkin, Everton; K, Wilson; D, Bragg; A, Akbari; A, Awodiya; S, A Osula; F, Gerges; I, Gerogiannis; L, Daniels; S, Seth; Z, Baxter; E, Nour; L, Fitchford; 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[10.1111/anae.16220]
Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study
Porcu, AlbertoMembro del Collaboration Group
;Perra, TeresaMembro del Collaboration Group
;Madonia, MMembro del Collaboration Group
;Scognamillo, FMembro del Collaboration Group
;Scanu, AMembro del Collaboration Group
;Fancellu, AMembro del Collaboration Group
;Feo, C;Cossu, MLMembro del Collaboration Group
;Ginesu, GCMembro del Collaboration Group
;Dessole, SMembro del Collaboration Group
;Capobianco, G;Petrillo, M;
2024-01-01
Abstract
Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause mortality. We performed a prospective, international cohort study between January 2022 and May 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries across Europe. The primary outcome measure was cardiovascular complications as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care initiative up to 30 days after surgery. The secondary outcome was 30-day postoperative mortality. This study included 24,203 patients, of whom 611 (2.5%) developed cardiovascular complications. In total, 458 (1.9%) patients died within 30 days of surgery, of which 123 (26.9%) deaths were judged to be cardiac-related. Mortality rates were higher in patients who developed postoperative cardiovascular complications than in those who did not (19.8% vs. 1.4%), which persisted after risk adjustment (hazard ratio (95%CI) 4.15 (3.14-5.48)). We estimated an absolute risk reduction (95%CI) of 0.4 (0.3-0.5) in mortality in the absence of all cardiovascular complications. This would confer a relative risk reduction in mortality of 21.1% if all cardiovascular complications were prevented. Postoperative cardiovascular complications are relatively common and occur early after major abdominal surgery. However, over 1 in 5 postoperative deaths were attributable to these complications, highlighting an important area for future randomised trials.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
