Desfechos cardiovasculares em perioperatório de cirurgias não cardíacas em um hospital do norte do Rio Grande do Sul

Abstract

Basis and Objective: Non-cardiac surgeries may present risks of perioperative cardiovascular events, being scores of risks and troponin elevation good independent predictors of morbidity and mortality and myocardial injury. The definition of Myocardial Injury after Non cardiac Surgery (MINS) includes, besides myocardial infarction, cardiac arrest and death after the procedure. We aimed to evaluate the clinical profile of patients in perioperative non-cardiac surgery and the relationship of cardiovascular risk scores with the prediction of cardiovascular outcomes and 30-day mortality. Method: Observational, retrospective cohort-type study, with data from hospital electronic medical records of patients undergoing non-cardiac surgery, between August and December 2019, in a tertiary care hospital. Results: Among the 83 patients, there was a predominance of men (55.4%) and elderly aged 61 years (±14.7), hypertension (60.2%), chronic renal (33.8%) and diabetic (13.2%). The occurrence of AMI, cardiac arrest and deaths within 30 days perioperatively was proportionally higher in patients with ASA 4 and 5, as well as those with moderate and high LEE and Goldmann Class II (p<0.005). High risk of MINS in urgent or emergency surgeries, with mortality of up to 100% in those diagnosed with AMI postoperatively, with more deaths in high-risk procedures. Conclusions: The incidence of MINS within 30 days postoperatively is related to higher mortality. Good predictors of cardiovascular events are low BMI, high ASA risk, LEE and Goldamnn, GFR < 60 ml/min, serum creatinine ≥ 2, and high-risk procedure.