ORIGINAL ARTICLES   

Chirurgia 2009 December;22(6):249-54

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Major abdominal nonvascular surgery is significant risk factor in coronary patients

Karapandzic V. M., Matic M. D., Milicevic M. N., Barovic S. V., Milicic B. R.

Department of Digestive Surgery, Institute for Digestive System Diseases, University Clinical Center of Serbia, Belgrade, Serbia

Aim. Major abdominal surgery is a significant predictor of increased perioperative morbidity and mortality in coronary patients.
Methods. Our prospective observational clinical study included the group of 111 consecutive patients with angiographicaly verified coronary artery disease, undergoing open abdominal nonvascular surgery in general anesthesia at the University hospital. Patients were divided in stratification subgroups according to duration of operation: shorter than 3 h - 75/111 (67.6%) patients and longer than 3 h - 36/111 (32.4%) patients. They were compared in relation to perioperative cardiac complications. Coronary patients were monitored by continuous electrocardiogram during the surgery as well as in the immediate postoperative 72-hour period. All patients had 12-lead electrocardiography immediately after the surgery, and on postoperative days 1, 2 and 7 as well as a day before discharge from hospital. Cardiac biomarkers were evaluated at 6 h, 24 h and 96 hours following the surgery. The patients were followed-up till 30th postoperative day.
Results. Statistical design was presented by Pearson’s c2 test and binomial logistic regression (univariate and multivariate analysis). Our study demonstrated statisticaly high significant difference between evaluated subgroups in relation to incidence of cardiac death until 30th postoperative day < 3 h – 0/75 (0.0%) vs > 3 h – 3/36 (8.3%) (p<0.01).
Conclusions. We found statistically high significant difference of the incidence of expected perioperative cardiac complications between stratification subgroups of coronary patients undergoing open abdominal nonvascular surgery in general anesthesia in relation to duration of operation.