Rate of Death and MI After Non-Cardiac Surgery Decreases, But Risk of Stroke Increases

If you need this type of surgery ask your doctor how they are reducing these post operative events.
Rate of Death and MI After Non-Cardiac Surgery Decreases, But Risk of Stroke Increases
Cardiovascular complications after non-cardiac surgery remain a major source of morbidity and mortality, according to a study published online by JAMA Cardiology.
Despite the significant burden perioperative events place on the national healthcare system, recent data are lacking on trends in perioperative major adverse cardiovascular and cerebrovascular events (MACCE) among patients hospitalised for major non-cardiac surgery.
Using the National Inpatient Sample, Sripal Bangalore, MD, New York University School of Medicine, New York, New York, and colleagues identified patients who underwent major non-cardiac surgery from January 2004 to December 2013.
Among 10,581,621 hospitalisations (mean age, 66 years; 57% female) for major non-cardiac surgery, perioperative MACCE -- defined as in-hospital, all-cause death, acute myocardial infarction (MI) or acute ischaemic stroke -- occurred in 317,479 hospitalisations (3%), corresponding to an annual incidence of approximately 150,000 events.
MACCE occurred most frequently in patients undergoing vascular (7.7%), thoracic (6.5%), and transplant surgery (6.3%).
Between 2004 and 2013, the frequency of MACCE declined from 3.1% to 2.6%, driven by a decline in frequency of perioperative death and acute MI, but there was an increase in perioperative ischaemic stroke from 0.52% in 2004 to 0.77% in 2013.
Men had higher risk of perioperative MACCE than women. In analyses of perioperative events by race and ethnicity, non-Latino black patients had the highest rates of perioperative death and ischaemic stroke compared with other racial groups.
“Perioperative MACCE occurs in 1 of every 33 hospitalisations for non-cardiac surgery,” the authors wrote. “Despite improvements in perioperative outcomes over the past decade, the significant increase in the rate of ischaemic stroke in this analysis requires confirmation and further study. Additional efforts are necessary to improve perioperative cardiovascular care of patients undergoing non-cardiac surgery.”
SOURCE: JAMA Cardiology