Evidence map›Paper›PMID 39350024›Full record

ArticleBMC anesthesiology2024

Preoperative electrocardiogram in prediction of 90-day postoperative mortality: retrospective cohort study.

Bronislav Čapek, Jan Václavík, Klára Benešová, Jiří Jarkovský

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Article in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Bronislav ČapekDepartment of Internal Medicine, Associated Medical Facility Krnov, I. P. Pavlova 9, Krnov, 794 01, Czech Republic. capekb@gmail.com.
Jan VáclavíkDepartment of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic.
Klára BenešováInstitute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
Jiří JarkovskýInstitute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are conflicting data on the relationship between preoperative electrocardiogram and postoperative mortality. We aimed to assess the predictive value of preoperative ECG on postoperative all-cause mortality in patients undergoing non-cardiac surgery (NCS).

methodsWe retrospectively reviewed records of hospitalized patients who underwent an internal preoperative examination and subsequent NCS in the years 2015-2021. We recorded patient comorbidities, vital functions, results of biochemical tests, ECG. The primary end point was 90-day postoperative all-cause mortality, acquired from the hospital records and the nationwide registry run by the Institute of Health Information and Statistics of the Czech Republic.

resultsWe enrolled a total of 2219 patients of mean age 63 years (48% women). Of these, 152 (6.8%) died during the 90-day postoperative period. There were statistically significant associations between increased 90-day postoperative all-cause mortality and abnormal ECG findings in resting heart rate (≥ 80 bpm, relative risk [RR] = 1.82 and ≥ 100 bpm, RR = 2.57), presence of atrial fibrillation (RR = 4.51), intraventricular conduction delay (QRS > 0.12 s, RR = 2.57), ST segment changes and T wave alterations, left bundle branch hemiblock (RR = 1.64), and right (RR = 2.04) and left bundle branch block (RR = 4.13), but not abnormal PQ and QT intervals, paced rhythm, incomplete right bundle branch block, or other ECG abnormalities. A resting heart rate (≥ 80 bpm, relative risk [RR] = 1.95 and ≥ 100 bpm, RR = 2.20), atrial fibrillation (RR = 2.10), and right bundle branch block (RR = 2.52) were significantly associated with 90-day postoperative all-cause mortality even in subgroup of patients with pre-existing cardiac comorbidities.

conclusionsPatients with abnormal preoperative ECG findings face an elevated risk of all-cause mortality within 90 days after surgery. The highest mortality risk is observed in patients with atrial fibrillation and left bundle branch block. Additionally, an elevated heart rate, right bundle branch block, and atrial fibrillation further increase the risk of death in patients with pre-existing cardiac conditions.

Indexed as

ElectrocardiographyPostoperative ComplicationsAgedCohort StudiesCzech RepublicFemaleHumansMaleMiddle AgedPredictive Value of TestsPreoperative CareRetrospective StudiesAtrial fibrillationBundle branch blockHeart rateMortalityPreoperative electrocardiogram

Identifiers

PMID39350024
PMCPMC11440682

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.