Preoperative exercise echocardiography and perioperative cardiovascular outcomes in elderly patients undergoing cancer surgery Journal Article
| Authors: | Shoyeb, A.; Weinstein, H.; Roistacher, N.; Spaltro, B.; Bates, A.; Yusim, G.; Steingart, R. |
| Article Title: | Preoperative exercise echocardiography and perioperative cardiovascular outcomes in elderly patients undergoing cancer surgery |
| Abstract: | Limited information is available on the value of exercise echocardiography (EE) for identifying operative risk in elderly patients undergoing noncardiac surgery. The authors investigated the outcome in 221 consecutive patients 75 years and older who had EE before intermediate- or high-risk cancer surgery. Baseline clinical data, postoperative adverse cardiovascular events (PACE), and 30-day mortality were collected from the medical records and the Social Security Death Index. The mean age +/- SD of the group was 78.9+/-3.5 years; 57% were men. Significant cardiovascular abnormalities (by echocardiography) were present in 71.5%. Mean metabolic equivalents +/- SD achieved during exercise was 4.9+/-1.9. EE identified 50 (22.6%) patients with ischemia and/or infarction. Perioperative beta-blockers were used in 80% of patients with coronary artery disease vs 48.5% without coronary artery disease (P<.0001). There were 31 PACE in 26 (11.8%) patients. Atrial fibrillation was the most common PACE, seen in 18 (8.1%) patients, followed by congestive heart failure in 8 (3.6%), acute coronary syndrome in 2 (0.9%), and cardiac arrest in 1 (0.5%). Thirty-day mortality was only 0.9%. Hospital lengths of stay for patients with and without PACE were 16.8+/-14.9 and 8.5+/-4.8 days (P< or =.0001), respectively. An abnormal EE predicted PACE (22% vs 8.8%; P< .025). Perioperative beta-blockers reduced the incidence of postoperative atrial fibrillation (4.9% vs 12.2%; P=.052). In conclusion, EE is feasible in very elderly patients. There is a high prevalence of cardiac abnormalities in the elderly. An abnormal EE predicts PACE, which, in turn, is associated with increased length of stay. |
| Keywords: | survival; treatment outcome; aged; aged, 80 and over; survival analysis; retrospective studies; pathophysiology; research design; methodology; neoplasm; neoplasms; logistic models; incidence; retrospective study; postoperative complication; postoperative complications; hospitalization; severity of illness index; cardiovascular disease; cardiovascular diseases; echography; prediction and forecasting; predictive value of tests; statistical model; electrocardiography; heart stroke volume; stroke volume; stress echocardiography; heart rate; echocardiography, stress |
| Journal Title: | American Journal of Geriatric Cardiology |
| Volume: | 15 |
| Issue: | 6 |
| ISSN: | 1076-7460 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2006-11-01 |
| Start Page: | 338 |
| End Page: | 344 |
| Language: | English |
| DOI: | 10.1111/j.1076-7460.2006.05250.x |
| PUBMED: | 17086025 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 4 June 2012" - "Source: Scopus" |
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