title: [Cardiac complications of major elective non-cardiac surgery: incidence and risk factors].
abstract: OBJECTIVE
  Previous estimates of the incidence of cardiac complications following major elective surgery have all been obtained in populations with specific risk factors or in contexts that differ from those found in Spain. Our aims were to estimate the frequency of postoperative cardiac complications following major elective non-cardiac surgery in patients aged 40 years or more, and to identify associated risk factors.
  
  
  METHODS
  Prospective observational study of consecutive patients undergoing surgery between November 1997 and October 1999.
  
  
  RESULTS
  The overall incidence of postoperative cardiac complications was 9.6 (95% CI, 5.3-16): it was 1.9 (95% CI, 0.5-7.5) for superficial surgery, 36.2 (95% CI, 15.1-87) for deep surgery, and 150 (95% CI, 67.4-334) for peripheral vascular surgery. The risk of cardiac complications was greater in patients aged 75 years or more (relative risk [RR]=9.5; 95% CI, 2.6-34.9), in those with type-I diabetes (RR=7.1; 95% CI, 2.1-24.1), systolic blood pressure > or =180 mmHg (RR=5.8; 95% CI, 1.3-25.4), or electrocardiographic signs of ischemia (RR=25.3; 95% CI, 6-106.8), in those who had undergone deep or peripheral vascular surgery (RR=21; 95% CI, 5.4-81.6), and in those who experienced hypotensive episodes during surgery (RR=8.9; 95% CI, 2-39.1).
  
  
  CONCLUSIONS
  Cardiac complications occurred in 1% of consecutive patients aged 40 years or more in the three months following major elective non-cardiac surgery.
authors.affiliation: Centro de Salud Pública de Castellón, Castellón, Spain. jpuigb@terra.es
authors.forename: Joan
authors.initials: J
authors.lastname: Puig-Barberà
authors.forename: Soledad
authors.initials: S
authors.lastname: Márquez-Calderón
authors.forename: Miguel
authors.initials: M
authors.lastname: Vila-Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors