Perioperative Outcome and Long Term Mortality for Heart Failure Patients Undergoing Intermediate and High Risk Non-cardiac Surgery: Impact of Left Ventricular Ejection Fraction

摘要

The impact of left ventricular ejection fraction (EF) on outcome in patients with heart failure (HF) undergoing non-cardiac surgery has not been extensively evaluated. 174 subjects (mean age 75±12 years, 47% male, mean EF (47±18%) underwent intermediate or high risk non-cardiac surgery. Patients were stratified by EF and adverse perioperative complications were identified and compared. Adverse perioperative events occurred in 53 (30.5%) of subjects, including 14 (8.1%) deaths within 30 days, 26 (14.9%) myocardial infarctions, and 44 (25.3%) HF exacerbations. Among the factors associated with adverse perioperative outcomes in the first 30 days were advanced age (e.g. >80 years), diabetes and a severely decreased EF (e.g. <30%). Long term mortality was high and Cox proportional hazards analysis demonstrated that EF was an independent risk factor for long term mortality.