Risk factors for postoperative adverse cardiovascular events in elderly patients undergone radical colectomy / 中华老年医学杂志

ABSTRACT

Objective:To analyze the risk factors for postoperative adverse cardiovascular events(PACE)in elderly patients after treatment with colectomy.Methods:Clinical data of 720 elderly patients aged 65 years and over treated with colectomy from January 2012 to December 2019 in Beijing Hospital, National Center of Gerontology were analyzed retrospectively.According to the occurrence of PACE(non-fatal myocardial infarction, acute coronary syndrome, arrhythmia, heart failure/cardiac insufficiency, etc.), the cases were divided into the PACE group and the non-PACE group.Clinical data of the two groups were compared and the risk factors for PACE were investigated using multivariate Logistic regression.Results:The overall incidence of PACE was 5.8%(42/720). Statistically significant differences were found between the PACE and non-PACE groups in patient age, the American Society of Anesthesiologists(ASA)classification, the Goldman index score and comorbidities(coronary heart disease, arrhythmia, old myocardial infarction, chronic renal insufficiency), preoperative serum levels of BNP and D-dimmer, and postoperative length of stay( P<0.05). A further multivariate Logistic regression analysis showed that significant differences existed between the groups in NYHA Ⅲ and Ⅳ, ASA Ⅲ and old myocardial infarction, with the overall risk of PACE increasing by 4.017, 2.320 and 2.746, respectively. Conclusions:The incidence of PACE following colectomy is related to multiple perioperative factors.For elderly colorectal cancer patients with one or more of the above risk factors, we should be on high alert for PACE during hospitalization.