Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery
Background - Perioperative myocardial ischemia (PMI) after non-cardiac surgery remains a serious postoperative complication. This study analyzed the risk factors and outcomes of patients who suffered from PMI after elective aortic surgery. - Patients and Methods - Data from 863 patients who underwen...
Gespeichert in:
| Hauptverfasser: | , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
15 December 2021
|
| In: |
Annals of vascular surgery
Year: 2022, Jahrgang: 78, Pages: 209-219 |
| ISSN: | 1615-5947 |
| DOI: | 10.1016/j.avsg.2021.04.046 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.avsg.2021.04.046 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0890509621004428 
|
| Verfasserangaben: | Dmitriy I. Dovzhanskiy, Petra Jäckel, Moritz S. Bischoff, Maani Hakimi, Ulf Hinz, Dittmar Böckler |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 182450862X | ||
| 003 | DE-627 | ||
| 005 | 20240326080332.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 221206s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.avsg.2021.04.046 |2 doi | |
| 035 | |a (DE-627)182450862X | ||
| 035 | |a (DE-599)KXP182450862X | ||
| 035 | |a (OCoLC)1361670126 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Dovzhanskiy, Dmitriy I. |e VerfasserIn |0 (DE-588)116518446X |0 (DE-627)1029344698 |0 (DE-576)510295193 |4 aut | |
| 245 | 1 | 0 | |a Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery |c Dmitriy I. Dovzhanskiy, Petra Jäckel, Moritz S. Bischoff, Maani Hakimi, Ulf Hinz, Dittmar Böckler |
| 264 | 1 | |c 15 December 2021 | |
| 300 | |a 11 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Gesehen am 06.12.2022 | ||
| 520 | |a Background - Perioperative myocardial ischemia (PMI) after non-cardiac surgery remains a serious postoperative complication. This study analyzed the risk factors and outcomes of patients who suffered from PMI after elective aortic surgery. - Patients and Methods - Data from 863 patients who underwent elective aortic surgery for aneurysms or Leriche syndrome were retrospectively analysed with regard to PMI. The diagnosis of PMI was based on a positive serum troponin diagnostic test. According to the clinical signs and symptoms, the patients with PMI were divided into two groups: symptomatic and asymptomatic patients. Comorbidities, preoperative medication, intraoperative parameters, postoperative complications, mortality, length of intensive care stay and hospitalisation, as well as the long-term follow-up, were compared in a matched-pair analysis (1:3) with patients without PMI. Logistic regression analyses were performed to identify independent risk factors for PMI. - Results - Thirty-two patients with PMI were identified. Cardiac comorbidities (previous myocardial ischemia, P = 0.0099; left ventricular systolic dysfunction, P = 0.0429), ASA score ≥III (P = 0.0114) and preoperative elevated creatinine (P = 0.0194) were more common in patients who suffered PMI. The regression analysis confirmed that peripheral artery disease and prolonged operative duration >180 min are significant predictors of PMI. Surgical complications (wound healing deficit, P = 0.0027; rate of secondary interventions during primary admission, P = 0.0057) and medical complications (pneumonia, P = 0.0002; renal dysfunction, P = 0.0041) were more common in patients with PMI compared to the control group. Patients who suffered PMI remained in intensive care for a significantly longer period (P = 0.0001) and were also hospitalized for longer (P = 0.0001) than the control group. The long-term survival of patients who suffered PMI after aortic surgery was significantly worse than the control group (P < 0.0001, median 53 vs. 84 months), independent of clinical ischemia-associated symptoms. - Conclusions - PMI after aortic surgery not only affects long-term survival, but also correlates with worsening of surgical outcome. Thus, meticulous preoperative risk stratification is required for high-risk patients, together with routine postoperative monitoring of troponin levels after aortic surgery. | ||
| 700 | 1 | |a Jäckel, Petra |d 1986- |e VerfasserIn |0 (DE-588)1066504393 |0 (DE-627)817660429 |0 (DE-576)426019334 |4 aut | |
| 700 | 1 | |a Bischoff, Moritz |d 1981- |e VerfasserIn |0 (DE-588)138828180 |0 (DE-627)70312109X |0 (DE-576)309269245 |4 aut | |
| 700 | 1 | |a Hakimi, Maani |d 1972- |e VerfasserIn |0 (DE-588)130842494 |0 (DE-627)506359727 |0 (DE-576)298370891 |4 aut | |
| 700 | 1 | |a Hinz, Ulf |e VerfasserIn |0 (DE-588)1022150499 |0 (DE-627)716927748 |0 (DE-576)175505284 |4 aut | |
| 700 | 1 | |a Böckler, Dittmar |d 1966- |e VerfasserIn |0 (DE-588)1032367881 |0 (DE-627)738382868 |0 (DE-576)173503969 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Annals of vascular surgery |d Orlando, Fla. : Elsevier, 1986 |g 78(2022), Seite 209-219 |h Online-Ressource |w (DE-627)269019731 |w (DE-600)1473891-0 |w (DE-576)113948069 |x 1615-5947 |7 nnas |a Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery |
| 773 | 1 | 8 | |g volume:78 |g year:2022 |g pages:209-219 |g extent:11 |a Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery |
| 856 | 4 | 0 | |u https://doi.org/10.1016/j.avsg.2021.04.046 |x Verlag |x Resolving-System |z lizenzpflichtig |3 Volltext |
| 856 | 4 | 0 | |u https://www.sciencedirect.com/science/article/pii/S0890509621004428 |x Verlag |z lizenzpflichtig |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20221206 | ||
| 993 | |a Article | ||
| 994 | |a 2022 | ||
| 998 | |g 1032367881 |a Böckler, Dittmar |m 1032367881:Böckler, Dittmar |d 910000 |d 910200 |e 910000PB1032367881 |e 910200PB1032367881 |k 0/910000/ |k 1/910000/910200/ |p 6 |y j | ||
| 998 | |g 1022150499 |a Hinz, Ulf |m 1022150499:Hinz, Ulf |d 910000 |d 910200 |e 910000PH1022150499 |e 910200PH1022150499 |k 0/910000/ |k 1/910000/910200/ |p 5 | ||
| 998 | |g 130842494 |a Hakimi, Maani |m 130842494:Hakimi, Maani |d 50000 |e 50000PH130842494 |k 0/50000/ |p 4 | ||
| 998 | |g 138828180 |a Bischoff, Moritz |m 138828180:Bischoff, Moritz |d 910000 |d 910200 |d 50000 |e 910000PB138828180 |e 910200PB138828180 |e 50000PB138828180 |k 0/910000/ |k 1/910000/910200/ |k 0/50000/ |p 3 | ||
| 998 | |g 1066504393 |a Jäckel, Petra |m 1066504393:Jäckel, Petra |p 2 | ||
| 998 | |g 116518446X |a Dovzhanskiy, Dmitriy I. |m 116518446X:Dovzhanskiy, Dmitriy I. |d 910000 |d 910200 |e 910000PD116518446X |e 910200PD116518446X |k 0/910000/ |k 1/910000/910200/ |p 1 |x j | ||
| 999 | |a KXP-PPN182450862X |e 4225350134 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"origin":[{"dateIssuedDisp":"15 December 2021","dateIssuedKey":"2022"}],"relHost":[{"pubHistory":["1.1986 -"],"note":["Gesehen am 21.08.2009"],"language":["eng"],"part":{"volume":"78","year":"2022","text":"78(2022), Seite 209-219","extent":"11","pages":"209-219"},"disp":"Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgeryAnnals of vascular surgery","type":{"media":"Online-Ressource","bibl":"periodical"},"recId":"269019731","origin":[{"publisher":"Elsevier ; Springer","dateIssuedDisp":"1986-","dateIssuedKey":"1986","publisherPlace":"Orlando, Fla. ; New York, NY"}],"title":[{"title_sort":"Annals of vascular surgery","title":"Annals of vascular surgery","subtitle":"international journal of vascular surgery"}],"physDesc":[{"extent":"Online-Ressource"}],"id":{"zdb":["1473891-0"],"eki":["269019731"],"issn":["1615-5947"]}}],"id":{"doi":["10.1016/j.avsg.2021.04.046"],"eki":["182450862X"]},"physDesc":[{"extent":"11 S."}],"type":{"bibl":"article-journal","media":"Online-Ressource"},"title":[{"title_sort":"Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery","title":"Outcome analysis and risk factors for perioperative myocardial ischemia after elective aortic surgery"}],"note":["Gesehen am 06.12.2022"],"person":[{"role":"aut","family":"Dovzhanskiy","given":"Dmitriy I.","display":"Dovzhanskiy, Dmitriy I."},{"family":"Jäckel","role":"aut","given":"Petra","display":"Jäckel, Petra"},{"given":"Moritz","display":"Bischoff, Moritz","family":"Bischoff","role":"aut"},{"display":"Hakimi, Maani","given":"Maani","family":"Hakimi","role":"aut"},{"role":"aut","family":"Hinz","display":"Hinz, Ulf","given":"Ulf"},{"role":"aut","family":"Böckler","display":"Böckler, Dittmar","given":"Dittmar"}],"recId":"182450862X","name":{"displayForm":["Dmitriy I. Dovzhanskiy, Petra Jäckel, Moritz S. Bischoff, Maani Hakimi, Ulf Hinz, Dittmar Böckler"]},"language":["eng"]} | ||
| SRT | |a DOVZHANSKIOUTCOMEANA1520 | ||