Surgery in Cancer Patients: Risk Factors for Major Adverse Cardiac Events

Abstract

The major adverse cardiac events (MACE) are a major cause of perioperative death in patients of cancer combined with coronary heart disease. The risk factors of postoperative MACE in this specific population should be fully understood and analyzed to provide a theoretical basis for optimal management strategy. A total of 484 patients of cancer combined with coronary heart disease admitted to the intensive care unit of our hospital from January 2014 to December 2018 were retrospectively analyzed. The endpoint of observation was postoperative MACE. According to this endpoint, the patients were divided into the MACE group and the non-MACE group. The clinical baseline characteristics, additional examinations, and surgery-related indicators of the two groups were compared. Risk factors of MACE were analyzed by univariate and multivariate logistic analysis. A total of 56 patients (11.6%) were diagnosed with MACE during postoperative hospitalization in 484 patients. Univariate and multivariate logistic analyses were performed on the two groups: age (P = 0.021), history of heart failure (P = 0.033), history of angina within 6 months (P = 0.001), cardiac ejection fraction (P = 0.011), intraoperative hypoxia (P = 0.021), and intraoperative hypotension (P = 0.001) were Independent risk factors of MACE. The incidence of MACE was high in patients of cancer combined with coronary heart disease after non-cardiac surgery. Its independent risk factors include age, history of heart failure, history of angina within 6 months, cardiac ejection fraction, intraoperative hypoxia, and intraoperative hypotension.