Cardiac monitoring and cardiovascular event incidence in patients over 50 with ICU needs undergoing abdominal/vascular surgery: Insights from a tertiary care facility

Background

As the global population ages, the vulnerability of older adults (≥50 years) undergoing major non-cardiac surgeries increases significantly, posing greater risks and challenges. This study aims to address the gap in understanding postoperative cardiac complications and associated risk factors in this demographic.

Methods

A retrospective observational study was conducted to identify 100 patients aged 50 or older who underwent major abdominal or vascular surgeries requiring ICU admission for more than 24 h. MACE incidence, including myocardial infarction, unstable angina, heart failure, arrhythmias, stroke, and cardiac death, was assessed. Logistic regression analyzed preoperative risk factors.

Results

Postoperatively, 18 % experienced MACE events, including acute coronary syndrome, unstable angina, and cardiac death. Vascular surgeries correlated with increased mortality risk (p < 0.001). Hypertension emerged as a significant risk factor (OR 10.88, p < 0.02), alongside abnormal echocardiogram findings (p < 0.05).

Discussion

The study highlights the significant association of advanced age, hypertension, and echocardiographic abnormalities with MACE in elderly patients undergoing major abdominal/vascular surgeries requiring ICU care. The findings emphasize the importance of perioperative risk stratification, particularly in high-risk groups, to guide surgical planning and improve outcomes. Developing predictive tools, such as MACE risk calculators, could support clinical decision-making.

Conclusion

Age, hypertension, and echocardiographic findings are key MACE predictors in elderly surgical patients requiring ICU care. Future studies should focus on validating risk calculators and optimizing perioperative strategies to improve patient outcomes.