ArticlePloS one2019
Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: Guidelines of the German Society of Anaesthesiology and Intensive Care Medicine in collaboration with the German Association of the Scientific Medical Societies.Journal of clinical monitoring and computing · 2024Guideline
- The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.The Cochrane database of systematic reviews · 2021Pooled it
- Echocardiography before non-cardiac surgery: current knowledge, guideline recommendations, and clinical evidence - a narrative review.Journal of clinical monitoring and computing · 2026Review
- Echocardiography Does Not Delay Surgery in Elderly Patients with Hip Fractures, and Pulmonary Hypertension and Decreased Left Ventricular Ejection Fraction Are Associated with In-Hospital Mortality.Journal of clinical medicine · 2026Article
- Development of a prediction model integrating cardiac ultrasound parameters for cardiac complications after distal cholangiocarcinoma surgery: a retrospective cohort study.BMC medical imaging · 2026Article
- Review
- Prognostic value of stress CMR and SPECT-MPI in patients undergoing intermediate-to-high-risk non-cardiac surgery.La Radiologia medica · 2024Article
- Article
- Review
- Assessment and Management of Ischaemic Heart Disease in Non-Cardiac Surgery.Heart international · 2023Review
- Article
- Preoperative Transthoracic Echocardiography Predicts Cardiac Complications in Elderly Patients with Coronary Artery Disease Undergoing Noncardiac Surgery.Clinical interventions in aging · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiovascular events are the leading cause of perioperative complications among patients undergoing noncardiac surgery. However, the role of echocardiography for preoperative cardiac risk stratification prior to major noncardiac surgery is still controversial.
methodsThis retrospective study included a total of 1453 patients (51% male; age, 67 ± 16) who underwent intermediate- or high-risk major abdominal surgery or orthopedic surgery at two medical centers in South Taiwan between February 2013 and June 2016. All patients underwent preoperative transthoracic echocardiography (TTE). All of the included patients were followed up for 56 days after surgery. The primary endpoints were major adverse events (MAEs), i.e., all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs).
resultsA total of 35 patients (2.4%) reached the primary endpoint: 24 patients (1.6%) died, and 17 patients (1.2%) had MACCEs. Patients with postsurgery MAEs had higher average E/e' values, a lower Left ventricular (LV) ejection fraction, and higher prevalence of significant mitral regurgitation (MR) and moderate-advanced chronic kidney disease (CKD). Multivariate analysis showed that the modified Lee index and significant MR were independent prognostic predictors of MAEs.
conclusionPreoperative identification of significant MR on TTE is associated with increased MAEs at 56 days compared with that predicted by the modified Lee index alone in patients undergoing intermediate- or high-risk noncardiac surgery.
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