A two-center survey of cardiac events and peri-operative managements of cardiac patients undergoing non-cardiac surgery in Taiwanese population.
BACKGROUND
The risk of cardiac patients undergoing noncardiac surgery is relatively high. Successful preoperative evaluation and perioperative anesthetic management of a patient require a good communication among the patient, the anesthesiologist and the surgeon as well as excellent cooperation between the surgeon and anesthesiologist with a tacit understanding of the peri-operative risks. Peri-operative risk factors have been readily investigated in Caucasians or Westerners. As different ethnic populations may have different risk factors for a same disease entity, understanding the uniqueness in this respect in Taiwanese is mandatory. The purpose of this study is to examine the risk factors, perioperative cardiac events and the qualities of preoperative preparation and post-operative intensive care in Taiwanese cardiac patients undergoing noncardiac surgery.


METHODS
Two medical centers in Taiwan worked out a set of prospective questionnaire to evaluate the preoperative preparation, intraoperative events, and postoperative care of cardiac patients undergoing noncardiac surgery in these hospitals.


RESULTS
Between March 2002 and May 2002, there were 196 cardiac patients undergoing noncardiac surgery out of a total of 10,129 anesthetized surgical patients in two medical centers. The risk factors of these patients included coronary artery disease, hypertension, diabetes mellitus, congestive heart failure, arrhythmia, and renal function impairment. In these 196 cases, only 26.5% (52) and 16.8% (33) had been preoperatively evaluated by cardiologist and anesthesiologist respectively through consultation. The number of pre-operation specific cardiac tests totaled 34, and 41 patients (20.9%) required post-operative intensive care. There were two peri-operative fatalities and fourteen peri-operative cardiac events.


CONCLUSIONS
The quality of care for preoperative evaluation and quality assurance need to be improved in Taiwan.
Poon
Kin-Shing
KS
Department of Anesthesiology, Pain Service & Critical Care Medicine, China Medical College Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan, R.O.C. kspoonhk@seed.net.tw
Lee
Ming-Chien
MC
Yang
Min-Wen
MW
Chang
Wen-Kuei
WK
Chen
Chia-Chen
CC
Wu
King-Chuen
KC
Wu
Rick Sai-Chuen
RS
D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007431:Intraoperative Complications; D019990:Perioperative Care / Q000379:methods*; D011182:Postoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D013624:Taiwan