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Practical role of preoperative echocardiography in low-risk non-cardiac surgery

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dc.contributor.author이혜선-
dc.contributor.author최의영-
dc.contributor.author한동우-
dc.date.accessioned2023-04-20T08:19:16Z-
dc.date.available2023-04-20T08:19:16Z-
dc.date.issued2023-01-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/194062-
dc.description.abstractBackground: Due to increased needs to reduce non-fatal as well as fatal cardiac events, preoperative echocardiography remains part of routine clinical practice in many hospitals. Data on the role of preoperative echocardiography in low-risk non-cardiac surgery (NCS) other than ambulatory surgeries do not exist. We aimed to investigate the role of preoperative echocardiography in predicting postoperative adverse cardiovascular events (CVEs) in asymptomatic patients undergoing low-risk NCS. Methods: The study population was derived from a retrospective cohort of 1,264 patients who underwent elective low-risk surgery at three tertiary hospitals from June 1, 2021, to June 30, 2021. Breast, distal bone, thyroid, and transurethral surgeries were included. Preoperative examination data including electrocardiography, chest radiography, and echocardiography were collected. The primary outcome was a composite of postoperative adverse CVEs including all-cause death, myocardial infarction, cerebrovascular events, newly diagnosed or acutely decompensated heart failure (HF), lethal arrhythmia such as sustained ventricular tachycardia/fibrillation, and new-onset atrial fibrillation within 30 days after the index surgery. Results: Preoperative echocardiography was performed in 503 patients (39.8%), most frequently in patients with breast surgery (73.5%), followed by transurethral (37.7%), distal bone (21.6%), and thyroid surgeries (11.9%). Abnormal findings were observed in 5.0% of patients with preoperative echocardiography. Postoperative adverse CVEs occurred in 10 (0.79%) patients. Although a history of previous HF was an independent predictor of postoperative CVE occurrence (adjusted odds ratio, aOR: 17.98; 95% confidence interval, CI: 1.21–266.71, P = 0.036), preoperative echocardiography did not significantly predict CVE in multivariate analysis (P = 0.097). However, in patients who underwent preoperative echocardiography, the presence of abnormal echocardiographic findings was independently associated with development of CVE after NCS (aOR: 23.93; 95% CI: 1.2.28–250.76, P = 0.008). In particular, the presence of wall motion abnormality was a strong predictor of postoperative adverse CVE. Conclusion: In real-world clinical practice, preoperative echocardiography was performed in substantial number of patients with potential cardiac risk even in low-risk NCS, and abnormal findings were independently associated with postoperative CVE. Future studies should identify patients undergoing low-risk NCS for whom preoperative echocardiography would be helpful to predict adverse CVE.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherFrontiers Media S.A.-
dc.relation.isPartOfFRONTIERS IN CARDIOVASCULAR MEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titlePractical role of preoperative echocardiography in low-risk non-cardiac surgery-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentYonsei Biomedical Research Center (연세의생명연구원)-
dc.contributor.googleauthorEun Kyoung Kim-
dc.contributor.googleauthorHong-Mi Choi-
dc.contributor.googleauthorJong-Hwan Lee-
dc.contributor.googleauthorDong Woo Han-
dc.contributor.googleauthorHye Sun Lee-
dc.contributor.googleauthorEui-Young Choi-
dc.identifier.doi10.3389/fcvm.2023.1088496-
dc.contributor.localIdA03312-
dc.contributor.localIdA04165-
dc.contributor.localIdA04274-
dc.relation.journalcodeJ04002-
dc.identifier.eissn2297-055X-
dc.identifier.pmid36755797-
dc.subject.keywordcardiovascular event-
dc.subject.keywordechocardiography-
dc.subject.keywordnon-cardiac surgery-
dc.subject.keywordnon-cardiac surgery peri-operative-
dc.subject.keywordnon-cardiac surgery risk stratification-
dc.contributor.alternativeNameLee, Hye Sun-
dc.contributor.affiliatedAuthor이혜선-
dc.contributor.affiliatedAuthor최의영-
dc.contributor.affiliatedAuthor한동우-
dc.citation.volume10-
dc.citation.startPage1088496-
dc.identifier.bibliographicCitationFRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.10 : 1088496, 2023-01-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers

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