3、4级非心脏手术患者围手术期发生主要心脏并发症的危险因素分析

Risk factors for perioperative major cardiac complications in patients receiving grade 3,4 noncardiac surgery

目的:探讨3、4级非心脏手术患者围手术期发生主要心脏并发症的危险因素。方法:2018年2月至2020年12月,回顾性收集899例我院3、4级非心脏手术患者的临床资料,采用logistic回归分析其围手术期发生主要心脏并发症的危险因素。结果:共发生主要心脏并发症130例,发生率为14.46%。年龄≥68岁、缺血性心脏病史、心力衰竭病史、心律失常病史、高血压病史、慢性阻塞性肺疾病史、脑血管病史、手术级别高、全身麻醉、术前Scr>2 mg/ml、术前cTnI≥0.2 ng/ml、术前NT-proBNP>201 pg/ml为3、4级非心脏手术患者围手术期发生主要心脏并发症的独立危险因素(P<0.05)。结论:3、4级非心脏手术患者围手术期主要心脏并发症的发生率较高,危险因素较多,临床应重点关注相关危险因素,并加强术前评估与围手术期管理。

Objective:To explore the risk factors for perioperative major cardiac complications in patients receiving grade 3,4 noncardiac surgery.Methods:From February 2018 to December 2020,the clinical data of 899 patients receiving grade 3,4 noncardiac surgery in our hospital were retrospectively collected.Logistic regression analysis was used to analyze the risk factors for perioperative major cardiac complications.Results:A total of 130 cases of major cardiac complications occurred with an incidence of 14.46%.Age≥68 years old,history of ischemic heart disease,history of heart failure,history of arrhythmia,history of hypertension,history of chronic obstructive pulmonary disease,history of cerebrovascular disease,high surgical grade,general anesthesia,preoperative Scr>2 mg/ml,preoperative cTnl≥0.2 ng/ml,and preoperative NT-proBNP>201 pg/ml were independent risk factors for perioperative major cardiac complications in patients receiving grade 3,4 noncardiac surgery(P<0.05).Conclusion:The incidence of perioperative major cardiac complications in patients receiving grade 3,4 noncardiac surgery is relatively high,and there are many risk factors.Clinical attention should be paid to relevant risk factors,and preoperative evaluation and perioperative management should be strengthened.