Perioperative Cardiac Outcome and its Predictors in Patients Undergoing Non-Cardiac Surgery in a Tertiary Care Hospital in South India - A Prospective Study

Background Perioperative cardiovascular complications are commonly encountered challenges for the clinician. As an ever increasing number of elderly patients with coronary artery disease (CAD) are undergoing major and minor surgeries, cardiovascular complications remain a major clinical problem and the numbers will increase in the future. Objective The objective of this study was 1. to study the incidence of myocardial damage and perioperative cardiac events 2. to find the risk factors of poor outcome Materials and Methods The correlation between perioperative myocardial damage and short- and long-term outcome was studied in 186 patients, aged 70 years above, undergoing non-cardiac surgery for a minimum duration of 30 minutes. Results This study showed a strong relation between postoperative myocardial damage and poor short term and long term prognosis. Elevated Troponin T was a strong predictor of mortality during and after surgery. In 33 % of the 186 patients with ASA physical status classification III or IV undergoing non-elective surgery, myocardial damage was detected. Preoperative cardiac damage was found to be a predictor of major adverse cardiac events (MACE) in the postoperative period. Conclusion In conclusion, this study stresses on the importance of detecting elevated cardiac markers in patients undergoing elective or emergency surgery. It also has identified predictors of poor outcome in the perioperative period that could be used as criteria for screening patients at risk.