A Study Of Perioperative Cardiovascular Events In Non-Cardiac Surgery

ABSTRACT

Background:Perioperative evaluation is an important step before considering a patient for surgery to deal with cardiovascular risk factors.The aim of the study is to e valuate the risk of cardiovascular events during perioperative period in non-cardiac & non-vascular surgery, even in patients with no previous evidence of cardiac disease.Material And Methods:All patients admitted in Orthopaedic, Surgery, Gynaecology department were evaluated clinically as well as with laboratory and radiological investigation. All patients with age > 40 years were subjected to electrocardiography. All the data was collected & recorded in standard Proforma. Clinical evaluation was done preoperatively & 24 hour post operatively. In patients developing cardiovascular complications, additional evaluation was done on the basis of need. Result:Highest number of patients undergoing elective non-cardiac surgery belonged to the younger age group. General surgery had the highest number of patients 45.3%, followed by Orthopaedics (36%), Gynaecology (18.7%). In view of surgery done by 3 above-mentioned surgical branches, there was not much difference in the rate of risk ofcardiovascular events. Diabetes mellitus, hypertension, and cardiac diseases were found as frequent risk factors (44 (29.3%), 52 (34.6%), 26 (17.3%) respectively.) Postoperative cardiovascular complication rate was most commonly seen in cardiac diseases, which were 8 (30.7%) patients. The incidence of perioperative cardiac complication in our study was 8.7% with 4% mortality. Conclusion:The incidence of complication was highest in patients undergoing high risk surgeries like intraperitoneal surgery. The RCRI classification was a good preoperative tool for risk stratification of patients undergoing non-cardiac surgery.