Perioperative medicine & outcomes
Consequences of preoperative cardiac stress testing—A cohort study
Authors' conclusion
Preoperative cardiac stress testing likely induces coronary angiography and cardiac interventions while decreasing use of noncardiac surgery and delaying surgery for patients who ultimately proceed to noncardiac surgery. Despite changes to processes of care, our results do not support a causal relationship between stress testing and postoperative mortality.
Study context
- Population
- Patients visiting a dedicated preoperative risk assessment and optimization clinic before noncardiac nonophthalmologic surgery, 2008–2018
- Participants
- 118,552 patients · 159,795 visits
- Exposure
- Preoperative functional cardiac stress testing vs no stress testing
- Outcome
- Downstream care after stress testing
Methodological detailscausal inference models, integrated health system
- Causal inference models
- Integrated health system
Main finding
As reported in the abstract
Stress testing vs No stress testingRelative risk (95% CI)
Coronary angiography
8.6(6.1–12.1)
Percutaneous coronary intervention
4.1(1.8–9.2)
Cardiac surgery
6.8(4.9–9.4)
Noncardiac surgery
0.77(0.75–0.79)
- Delay to noncardiac surgery, patients completing noncardiac surgery
- mean delay 28.3 days (95% CI 23.1–33.6)
Observational data: associations, not effects.
Further findings
Mortality (time-to-mortality and 1-year mortality)
- Higher mortality with stress testing in unadjusted analysis; no association in causal inference analyses
Original publication
Consequences of preoperative cardiac stress testing—A cohort study. J Clin Anesth. Published 5 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →