[Postoperative mortality a university Department of General Surgery: incidence of cardiac-related deaths].
OBJECTIVE
To evaluate the incidence of cardiac deaths following noncardiac nonvascular surgery.


METHODS
Retrospective survey.


METHODS
All patients undergoing mainly endocrinous and digestive surgery in a University department of general surgery between 1991 and 1996.


METHODS
Analysis of all deaths occurring intra- and postoperatively, until discharge of the patients. Demographic and medical data, including patent myocardial ischaemia and risk factors for coronary artery disease, were recorded and compared with a control group including all patients undergoing surgery from January to September 1996.


RESULTS
In the 8,700 patients who underwent mainly endocrine neck surgery (66%), or intra-abdominal surgery (31%), the mortality rate (n = 96) was 1.1% (95% confidence interval [95% CI] = 0.9-1.3%). Patent myocardial ischaemia or high risk factors for coronary artery disease were existing in 24% of patients with neck surgery, 31% of those with intra-abdominal surgery, and in 60% of the deceased patients (P < 0.01 vs control group). Those who died were older, were in a higher ASA physical class, and had undergone an emergency procedure more often than patients of the control group (P < 0.002 for each parameter). Two cardiac deaths, in patients with a patent cardiopathy, were recorded (cardiac mortality: 0.02%; 95% CI = 0.003-0.08%). The main cause of death was infection (n = 46), followed by haemorrhage (n = 12). Seven deaths remained unexplained.


CONCLUSIONS
This study suggests that cardiac morbidity is a rare cause of death after noncardiac nonvascular surgery.
Tavernier
B
B
Service d'anesthésie-réanimation chirurgicale 2, Hôpital Claude-Huriez, CHRU, Lille, France.
Sanchez
R
R
Pattou
F
F
Mallat
J
J
Sperandio
M
M
Proye
C
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D001424:Bacterial Infections / Q000401:mortality; D002423:Cause of Death; D016001:Confidence Intervals; D003327:Coronary Disease / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D013505:Digestive System Surgical Procedures / Q000401:mortality; D013507:Endocrine Surgical Procedures / Q000401:mortality; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000401:mortality*