Risks of having a cardiac death or heart attack after non-cardiac surgery

In an extensive review (and the first of a two-part series in CMAJ) P.J. Devereaux and colleagues review what is know about the frequency of these risks and their causes.

Substantial advances in treating diseases that had high morality rates (like cancer and heart disease) and in improving quality of life with surgery such as arthroplasty have resulted in large increases in the number of people undergoing non-cardiac surgery.

Worldwide such surgery is growing, and annually 500 000 to 900 000 patients experience and unexpected perioperative cardiac death, nonfatal myocardial infarction or a non-fatal cardiac arrest.

Devereaux and colleagues critically and systematically review the reasons for the tools that clinicians can use to estimate risk pre-operatively. [In the second article they review what we know about preventing these outcomes.]

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk

-- P.J. Devereaux et al

http://www.cmaj.ca/misc/press/pg627.pdf

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