Heart failure

Comparison of outcomes after non-cardiac surgery in patients with heart failure

For one study, researchers sought to compare the outcomes of HF patients with reduced and preserved ejection fractions after non-cardiac surgery. Compared to the general population, HF patients undergoing major non-cardiac surgery had a higher risk of morbidity and mortality. However, it was uncertain whether IC subtypes were associated with different levels of risk. The National Readmissions Database included CI patients 45 years of age or older who underwent non-cardiac surgery between January 1, 2010 and September 30, 2015. Adjusted postoperative outcome rates were calculated using multivariate logistic regression. All models were run with hospital-level clustering and sampling weights from the national readmission database. In addition, 41.1% had cardiopulmonary complications, 55.7% had non-cardiopulmonary complications and 5.4% died during hospitalization of the 296,057 weighted HF patients. [HF with reduced ejection fraction (HFrEF) 48.%1; HF with preserved ejection fraction (HFpEF) 51.9%] who has undergone non-cardiac surgery. The 30-day weighted readmission rate for 232,852 HF patients was 21.5%. HFrEF patients had adjusted odds ratios of 1.01 [95% confidence interval (CI), 0.99–1.04], 1.05 (95% CI, 1.02-1.07), 1.27 (95% CI, 1.21-1.34) and 1.08 (95% CI, 1.05- 1.12) for cardiopulmonary and non-cardiopulmonary complications, in-hospital mortality, and 30-day readmission, respectively, compared to HFpEF patients. Noncardiopulmonary complications, deaths, and readmissions after noncardiac surgery were all higher in patients with HFrEF. Data showed that for the increasing proportion of patients with IC undergoing non-cardiac surgery, perioperative therapy tailored to IC subtypes might have been essential. Even if there were no statistical differences between HF subtypes in terms of cardiopulmonary consequences, any intervention aimed at reducing the risk would have been clinically meaningful given the high rate of occurrence.

Source:journals.lww.com/annalsofsurgery/Abstract/2022/04000/Comparison_of_Perioperative_Outcomes_in_Heart.27.aspx