Predictors of Cardiac Events after Major Vascular Surgery

Abstract

Introduction: Patients who undergo major vascular surgery are at increased risk of perioperative cardiac complications. Our objective is to examine the relationship between preoperative clinical characteristics and perioperative myocardial infarction and/or cardiac arrest within 30 days of major vascular surgery (excluding vein and amputation). Methods: Multivariate logistic regression analysis of the American College of Surgeons' 2007 National Surgical Quality Improvement Program database was performed. From this multicenter, prospective database, 21,378 patients who underwent major vascular surgery were studied. Results: Myocardial infarction and/or cardiac arrest was diagnosed in 361 patients (1.7%) undergoing major vascular surgery. 30-day mortality was significantly higher in patients who developed myocardial infarction and/or cardiac arrest than those who did not (59.3% vs 2.3%, p<0.0001). Multivariate analysis of 56 preoperative variables demonstrated several important clinical determinants of adverse outcome as summarized in Table 1.