ArticleJournal of the American Geriatrics Society2021
Perioperative cardiovascular outcomes among older adults undergoing in-hospital noncardiac surgery.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07643792 (Fascia Iliaca Block Using Liposomal Bupivacaine for Analgesia After Hip Surgery), which is not on this map. Cited by 12 papers.
What it found
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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.
Fascia Iliaca Block Using Liposomal Bupivacaine for Analgesia After Hip Surgery: a Randomized Trial
Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Prevalence and prognostic relevance of perioperative myocardial injury/infarction after major noncardiac surgery in older patients.Age and ageing · 2026Observational
- Fully automated, deep learning, cardiac CT-based multimodal network for cardiovascular risk stratification in high-risk perioperative patients.European heart journal. Digital health · 2026Article
- Perioperative Cardiovascular Outcomes and Risk Assessment in Older Adults for Noncardiac Surgery.Current anesthesiology reports · 2025Article
- Article
- Analysis of risk factors and clinical application of cardiovascular complications following lower limb joint replacement surgery in elderly patients.BMC surgery · 2025Article
- Risk factors for general complications after hip or knee replacement surgery in elderly patients: a single-center study.BMC musculoskeletal disorders · 2025Article
- Article
- Perioperative adverse cardiac events predict post-discharge mortality after fragility hip fracture in elderly patients without cardiovascular disease.Journal of geriatric cardiology : JGC · 2024Article
- External Validation of the Revised Cardiac Risk Index and the Geriatric-Sensitive Perioperative Cardiac Risk Index in Oldest Old Patients Following Surgery Under Spinal Anaesthesia; a Retrospective Cross-Sectional Cohort Study.Clinical interventions in aging · 2023Article
- Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture.Journal of clinical medicine · 2022Article
- Cardiac Comorbidity Risk Score: Zero-Burden Machine Learning to Improve Prediction of Postoperative Major Adverse Cardiac Events in Hip and Knee Arthroplasty.Journal of the American Heart Association · 2022Observational
- Risk Factors for Perioperative Myocardial Infarction/Injury and Mortality Following Surgical Treatment of Proximal Femur Fractures: A Cohort Study.JB & JS open accessArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundOlder adults undergoing noncardiac surgery have a high risk of major adverse cardiovascular events (MACE). This study aims to estimate the magnitude of increased perioperative risk, and examine national trends in perioperative MACE following in-hospital noncardiac surgery in older adults compared to middle-aged adults.
designTime-series analysis of retrospective longitudinal data.
settingThe United States Agency for Healthcare Research and Quality National Inpatient Sample (NIS).
participantsHospitalizations for major noncardiac surgery among adults age ≥45 years between January 2004 and December 2014. MEASUREMENTS: Inpatient perioperative MACE was defined as a composite of in-hospital death, myocardial infarction (MI), and ischemic stroke. In hospital death was determined from the NIS discharge disposition. MI and ischemic stroke were defined by International Classification of Diseases, Ninth Revision codes.
resultsOf an estimated 55,349,978 surgical hospitalizations, 26,423,039 (47.7%) were for adults age 45-64, 14,231,386 (25.7%) age 65-74, 10,621,029 (19.2%) age 75-84 years, and 4,074,523 (7.4%) age ≥85 years. MACE occurred in 1,601,022 surgical hospitalizations (2.9%). Adults 65-74 (2.8%; aOR 1.16, 95% CI 1.14-1.17), 75-84 years (4.5%; aOR 1.30, 95% CI 1.28-1.32), and ≥85 years (6.9%; aOR 1.55, 95% CI 1.52-1.57) had greater risk of MACE than those 45-64 years (1.7%). From 2004 to 2014, MACE declined among adults 65-74 (3.1-2.5%, p < 0.001), 75-85 years (4.9-3.9%, p < 0.001), and ≥85 years (7.7-6.1%, p < 0.001), but was unchanged for adults age 45-64. Declines in MACE were driven by decreased MI and mortality despite increased stroke.
conclusionOlder adults accounted for half of hospitalizations, but experienced the majority of MACE. Older adults had greater adjusted odds of MACE than younger individuals. The proportion of perioperative MACE declined over time, despite increases in ischemic stroke. These data highlight risks of noncardiac surgery in older adults that warrant increased attention to improve perioperative outcomes.
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