Perioperative Outcome and Long‐Term Mortality for Heart Failure Patients Undergoing Intermediate‐ and High‐Risk Noncardiac Surgery: Impact of Left Ventricular Ejection Fraction
The impact of left ventricular ejection fraction (LVEF) on outcome in patients with heart failure (HF) undergoing noncardiac surgery has not been extensively evaluated. In this study, 174 patients (mean age, 75±12 years, 47% male, mean LVEF (47%±18%) underwent intermediate‐ or high‐risk noncardiac s...
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| container_title | Congestive heart failure (Greenwich, Conn.) |
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| creator | Healy, Kirsten O. Waksmonski, Carol A. Altman, Robert K. Stetson, Peter D. Reyentovich, Alex Maurer, Mathew S. |
| description | The impact of left ventricular ejection fraction (LVEF) on outcome in patients with heart failure (HF) undergoing noncardiac surgery has not been extensively evaluated. In this study, 174 patients (mean age, 75±12 years, 47% male, mean LVEF (47%±18%) underwent intermediate‐ or high‐risk noncardiac surgery. Patients were stratified by LVEF, and adverse perioperative complications were identified and compared. Adverse perioperative events occurred in 53 patients (30.5%), including 14 (8.1%) deaths within 30 days, 26 (14.9%) myocardial infarctions, and 44 (25.3%) HF exacerbations. Among the factors associated with adverse perioperative outcomes in the first 30 days were advanced age (>80 years), diabetes, and a severely decreased LVEF ( |
| doi_str_mv | 10.1111/j.1751-7133.2009.00130.x |
| format | Article |
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Congest Heart Fail. 2010;16:45–49. © 2009 Wiley Periodicals, Inc.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Health Status Indicators</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - mortality</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Odds Ratio</subject><subject>Perioperative Care - adverse effects</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - physiopathology</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Surgical Procedures, Operative</subject><subject>Time Factors</subject><subject>United States - epidemiology</subject><subject>Ventricular Function, Left</subject><issn>1527-5299</issn><issn>1751-7133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc2O0zAUhSMEYoaBV0B3xyrBjpMmQWxQNaWVOj-aH7aW494ElyTuXDsw3fEI8zTzQDwJbjvMGm98rHvOuZK_KALOEh7Ox3XCi5zHBRciSRmrEsa4YMn9i-j4efAy6Dwt4jytqqPojXNrxnIhyup1dJSyjKfZpDiOHi-RjN0gKW9-IlyMXtseQQ0rWNqh_fP74QaphzNLXnXGb6GxBHNU5GGmTDcSwmWI4uAd3A4rpNaaoYXF4EMMV0Z5DB37vrlpvwd9ZdwPOLeDVhTGGq5HapG2n2DRb5T2YBtYYuPhW-gko8dOEZyuUXtjB5iR2ou30atGdQ7fPd0n0e3s9GY6j5cXXxfTL8tYi6pkccFqbASrwqOuy5wzJYpMr7DQfIJZPRFpXdVcVVw3quR5UZZZ3mjVpGHGVZqLk-jDoXdD9m5E52VvnMauUwPa0clCiIoztneWB6cm6xxhIzdkekVbyZncQZNruWMjd2zkDprcQ5P3Ifr-aclYhz97Dv6jFAyfD4ZfpsPtfxfL6XwWhPgLq8CrXg</recordid><startdate>201003</startdate><enddate>201003</enddate><creator>Healy, Kirsten O.</creator><creator>Waksmonski, Carol A.</creator><creator>Altman, Robert K.</creator><creator>Stetson, Peter D.</creator><creator>Reyentovich, Alex</creator><creator>Maurer, Mathew S.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201003</creationdate><title>Perioperative Outcome and Long‐Term Mortality for Heart Failure Patients Undergoing Intermediate‐ and High‐Risk Noncardiac Surgery: Impact of Left Ventricular Ejection Fraction</title><author>Healy, Kirsten O. ; Waksmonski, Carol A. ; Altman, Robert K. ; Stetson, Peter D. ; Reyentovich, Alex ; Maurer, Mathew S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3980-70bef309398bb8510a374cde7c16e4b632b9b1a91cfa81578845fcaf24b61a253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Health Status Indicators</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - mortality</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Odds Ratio</topic><topic>Perioperative Care - adverse effects</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - physiopathology</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Surgical Procedures, Operative</topic><topic>Time Factors</topic><topic>United States - epidemiology</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Healy, Kirsten O.</creatorcontrib><creatorcontrib>Waksmonski, Carol A.</creatorcontrib><creatorcontrib>Altman, Robert K.</creatorcontrib><creatorcontrib>Stetson, Peter D.</creatorcontrib><creatorcontrib>Reyentovich, Alex</creatorcontrib><creatorcontrib>Maurer, Mathew S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Congestive heart failure (Greenwich, Conn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Healy, Kirsten O.</au><au>Waksmonski, Carol A.</au><au>Altman, Robert K.</au><au>Stetson, Peter D.</au><au>Reyentovich, Alex</au><au>Maurer, Mathew S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative Outcome and Long‐Term Mortality for Heart Failure Patients Undergoing Intermediate‐ and High‐Risk Noncardiac Surgery: Impact of Left Ventricular Ejection Fraction</atitle><jtitle>Congestive heart failure (Greenwich, Conn.)</jtitle><addtitle>Congest Heart Fail</addtitle><date>2010-03</date><risdate>2010</risdate><volume>16</volume><issue>2</issue><spage>45</spage><epage>49</epage><pages>45-49</pages><issn>1527-5299</issn><eissn>1751-7133</eissn><abstract>The impact of left ventricular ejection fraction (LVEF) on outcome in patients with heart failure (HF) undergoing noncardiac surgery has not been extensively evaluated. In this study, 174 patients (mean age, 75±12 years, 47% male, mean LVEF (47%±18%) underwent intermediate‐ or high‐risk noncardiac surgery. Patients were stratified by LVEF, and adverse perioperative complications were identified and compared. Adverse perioperative events occurred in 53 patients (30.5%), including 14 (8.1%) deaths within 30 days, 26 (14.9%) myocardial infarctions, and 44 (25.3%) HF exacerbations. Among the factors associated with adverse perioperative outcomes in the first 30 days were advanced age (>80 years), diabetes, and a severely decreased LVEF (<30%). Long‐term mortality was high, and Cox proportional hazards analysis demonstrated that LVEF was an independent risk factor for long‐term mortality.
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| subjects | Adrenergic beta-Antagonists - therapeutic use Aged Aged, 80 and over Angiotensin-Converting Enzyme Inhibitors - therapeutic use Confidence Intervals Female Health Status Indicators Heart Failure - complications Heart Failure - mortality Heart Failure - physiopathology Humans Kaplan-Meier Estimate Male Myocardial Ischemia - complications Myocardial Ischemia - mortality Myocardial Ischemia - physiopathology Odds Ratio Perioperative Care - adverse effects Postoperative Complications - mortality Postoperative Complications - physiopathology Proportional Hazards Models Retrospective Studies Risk Assessment Risk Factors Stroke Volume Surgical Procedures, Operative Time Factors United States - epidemiology Ventricular Function, Left |
| title | Perioperative Outcome and Long‐Term Mortality for Heart Failure Patients Undergoing Intermediate‐ and High‐Risk Noncardiac Surgery: Impact of Left Ventricular Ejection Fraction |
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