Incidence of and Risk Factors for Cardiovascular Complications After Thoracic Surgery for Noncancerous Lesions

Objective: The purpose of this study was to determine the incidence of and risk factors for cardiovascular complications after thoracic surgery for noncancerous lesions. Design: Retrospective cohort study. Setting: A tertiary medical center. Participants: All consecutive patients undergoing either thoracotomy or thoracoscopy for noncancerous lesions between 2005 and 2011 were included. Measurements and Main results: The primary outcomes were the incidence and types of cardiovascular complications such as cardiac arrhythmias, cardiac arrest, heart failure, and myocardial ischemia during hospitalization. A total of 719 patients were recruited, 60% of whom had infections. The incidence of cardiovascular complications after thoracic surgery was 6.7% (48 of 719), of which cardiac arrhythmia was the most common (25 of 48, 52%). The multivariate risk regression analysis showed that age >55 years (risk ratio [RR] = 4.0; 95% confidence interval [CI] = 2.1-7.5; p < 0.01), diabetes mellitus (RR = 3.0; 95% CI = 1.7-5.3; p < 0.01), coronary artery disease (RR = 4.8; 95% CI = 2.3-10.2; p < 0.01), duration of surgery >180 minutes (RR = 2.6; 95% CI = 1.3-5.1; p < 0.01), intraoperative hypotension (RR = 2.6; 95% CI = 1.6-4.3; p < 0.01), and positive fluid balance >2,000 mL (RR = 2.5; 95% CI = 1.4-4.5; p < 0.01) were independent risk factors for cardiovascular complications. Conclusions: Knowledge of risk factors could help surgical teams to identify high risk patients and adjust modifiable risk factors including optimization of medical conditions, correction of intraoperative hypotension, and appropriate blood and fluid administration in order to reduce perioperative morbidity and mortality. (C) 2014 Elsevier Inc. All rights reserved.