Perioperative medicine & outcomes
Preoperative Heart Failure Treatment Prevents Postoperative Cardiac Complications in Patients With Lower Risk: A Retrospective Cohort Study
Main findingResult — go to the resultAdjusted odds ratio 2.28 95% CI 2.02–2.56Authors' conclusion
In patients with heart failure who have a lower preoperative risk profile, clinicians often make insufficient attempts to optimize their clinical condition preoperatively. Preoperative preventive treatment reduces the risk of postoperative cardiac complications in these lower-risk patients with heart failure.
Study context
- Population
- Patients undergoing noncardiac surgeryhospital registry
- Participants
- 130,677 patients
- Exposure
- History of HF vs no HF
- Heart failuren = 10,256
- Outcome
- Cardiac complications:
- MI
- Cardiac arrest
- Acute HF
- Mortality
- Follow-up
- 30 postoperative days
Methodological detailshospital registry data
- Hospital registry data
Main finding
As reported in the abstract
Adjusted odds ratio
2.28
95% CI 2.02–2.56
P < 0.001
By group
Heart failure vs No heart failure
aOR 2.28 (95% CI 2.02–2.56); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted absolute risk difference (%) (95% CI) | P value | |
|---|---|---|---|
| Cardiac complications attributable to HF, lower-risk profile (subgroup)Lower risk | 1.7 (1.4%–2.0%) | P < 0.001 | |
| Cardiac complications attributable to HF, higher-risk profile (subgroup)Higher risk | 0.5 (−0.6% to 1.6%) | P = 0.38 | |
| −10123Difference, % (linear scale) |
Preoperative health care utilization and anti-HF medications, HF lower vs higher risk (subgroup)
- Preoperative health care utilization, lower vs higher risk
- 59% vs 72%
- Anti-HF medications, lower vs higher risk
- 61% vs 82%
- Both comparisons
- P < 0.001
Preventive therapies in HF
- Preventive therapies significantly decreased risk of cardiac complications in HF
Original publication
Preoperative Heart Failure Treatment Prevents Postoperative Cardiac Complications in Patients With Lower Risk: A Retrospective Cohort Study. Ann Surg. Published 1 February 2021. doi:10.
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