Cancer and the risk of perioperative arterial ischaemic events.

IF 4.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Quality of Care and Clinical Outcomes Pub Date : 2024-06-20 DOI:10.1093/ehjqcco/qcad057

Babak B Navi, Cenai Zhang, Jed H Kaiser, Vanessa Liao, Mary Cushman, Scott E Kasner, Mitchell S V Elkind, Scott T Tagawa, Saketh R Guntupalli, Mario F L Gaudino, Agnes Y Y Lee, Alok A Khorana, Hooman Kamel

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引用次数: 0

Abstract

Background and aims: Most cancer patients require surgery for diagnosis and treatment. This study evaluated whether cancer is a risk factor for perioperative arterial ischaemic events.

Methods: The primary cohort included patients registered in the National Surgical Quality Improvement Program (NSQIP) between 2006 and 2016. The secondary cohort included Healthcare Cost and Utilization Project (HCUP) claims data from 11 US states between 2016 and 2018. Study populations comprised patients who underwent inpatient (NSQIP, HCUP) or outpatient (NSQIP) surgery. Study exposures were disseminated cancer (NSQIP) and all cancers (HCUP). The primary outcome was a perioperative arterial ischaemic event, defined as myocardial infarction or stroke diagnosed within 30 days after surgery.

Results: Among 5 609 675 NSQIP surgeries, 2.2% involved patients with disseminated cancer. The perioperative arterial ischaemic event rate was 0.96% among patients with disseminated cancer vs. 0.48% among patients without (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.90-2.13). In Cox analyses adjusting for demographics, functional status, comorbidities, surgical specialty, anesthesia type, and clinical factors, disseminated cancer remained associated with higher risk of perioperative arterial ischaemic events (HR, 1.37; 95% CI, 1.28-1.46). Among 1 341 658 surgical patients in the HCUP cohort, 11.8% had a diagnosis of cancer. A perioperative arterial ischaemic event was diagnosed in 0.74% of patients with cancer vs. 0.54% of patients without cancer (HR, 1.35; 95% CI, 1.27-1.43). In Cox analyses adjusted for demographics, insurance, comorbidities, and surgery type, cancer remained associated with higher risk of perioperative arterial ischaemic events (HR, 1.31; 95% CI, 1.21-1.42).

Conclusion: Cancer is an independent risk factor for perioperative arterial ischaemic events.

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癌症与围手术期动脉缺血性事件的风险。

背景和目的：大多数癌症患者需要手术进行诊断和治疗。本研究评估了癌症是否是围手术期动脉缺血性事件的危险因素。方法：主要队列包括2006-2016年间在国家外科质量改进计划（NSQIP）中注册的患者。次要队列包括2016-2018年间美国11个州的医疗成本和利用项目（HCUP）索赔数据。研究人群包括接受住院（NSQIP，HCUP）或门诊（NSQID）手术的患者。研究暴露为扩散性癌症（NSQIP）和所有癌症（HCUP）。主要结果是围手术期动脉缺血性事件，定义为术后30天内诊断为心肌梗死或中风。结果：在5609675例NSQIP手术中，2.2%的患者为弥漫性癌症患者。弥漫性癌症患者的围手术期动脉缺血性事件发生率为0.96%，而非弥漫性癌症患者的发病率为0.48%（HR，2.01；95%CI，1.90-2.13），弥漫性癌症仍然与围手术期动脉缺血性事件的高风险相关（HR，1.37；95%CI，1.28-1.46）。在HCUP队列的1341658名外科患者中，11.8%诊断为癌症。在0.74%的癌症患者和0.54%的非癌症患者中诊断出围手术期动脉缺血性事件（HR，1.35；95%CI，1.27-1.43），癌症仍然与围手术期动脉缺血性事件的高风险相关（HR，1.31；95%CI，1.21-1.42）。结论：癌症是围手术期血管缺血性事件的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Quality of Care and Clinical Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

3.80%

发文量

期刊介绍： European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.