Abstract 18223: Postoperative Cardiac Events After Non-Cardiac Surgery in Patients Undergoing Dobutamine Stress Echocardiography
Background: Postoperative outcomes in patients undergoing pre-operative DSE across the spectrum of surgical risk in a large and contemporary cohort of patients undergoing non-cardiac surgery remain unclear. The aim of this study was to ascertain outcomes in patients among different operative risk categories undergoing preoperative DSE.
Methods: We evaluated 4,474 patients undergoing non-cardiac surgery within 90 days of a DSE performed between 2006-2011. We abstracted data including pre-operative baseline demographics, comorbidities, medications, operative characteristics, and 30-day perioperative cardiovascular events. We evaluated 8,513 consecutive patients with pre-operative DSEs performed between 2006-2011. Of these 4,474 went on to surgery within 90 days, with a majority of patients excluded secondary to not being pre-operative candidates (n=351), not undergoing surgery within 90 days (n=3,216), undergoing cardiac surgery (n=41), or patients undergoing a second surgery within 30 days of index surgery (n=431). Patients were divided into tertiles according to pre-operative surgical risk (low, medium, high).
Results: Cardiovascular outcomes in this population are presented in the figure below, and included physician diagnosis of MI (n=51, 1.1%), cardiac arrest (n=25, 0.6%), and all-cause mortality (n=40, 0.9%).
Conclusions: In conclusion, the rate of serious adverse cardiac events in patients undergoing non-cardiac surgery after a DSE is low across multiple pre-operative surgical risk categories. Patients undergoing low risk surgery did not experience any post-operative events. These findings suggest that clinicians should carefully consider resources they employ in pre-operative risk stratification, specifically among those undergoing low risk surgery.
Author Disclosures: R.J. Widmer: None. M.W. Cullen: None. D.R. Schroeder: None. R.B. McCully: None. K.F. Mauck: None.
- © 2016 by American Heart Association, Inc.