title: Risk factors for perioperative major cardiac events in Chinese elderly patients with coronary heart disease undergoing noncardiac surgery.
abstract: BACKGROUND
  Few studies have investigated perioperative major adverse cardiac events (MACEs) in elderly Chinese patients with coronary heart disease (CHD) undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncardiac surgery, and established a risk stratification system.
  
  
  METHODS
  This retrospective observational clinical study included 482 patients aged ≥60 years with CHD who underwent elective major noncardiac surgery at the Peking Union Medical College Hospital. The primary outcome was MACE within 30 days after surgery. Risk factors were evaluated using multivariate Logistic regression analysis.
  
  
  RESULTS
  Perioperative MACE occurred in 61(12.66%) of the study patients. Five independent risk factors for perioperative MACE were identified: history of heart failure, preoperative arrhythmia, preoperative diastolic blood pressure ≤75 mmHg, American Society of Anesthesiologists grade 3 or higher, and intraoperative blood transfusion. The area under the receiver operating characteristic curve for the risk-index score was 0.710±0.037. Analysis of the risk stratification system showed that the incidence of perioperative MACE increased significantly with increasing levels of risk.
  
  
  CONCLUSIONS
  Elderly Chinese patients with CHD who undergo noncardiac surgery have a high risk of perioperative MACE. Five independent risk factors for perioperative MACE were identified. Our risk stratification system may be useful for assessing perioperative cardiac risk in elderly patients undergoing noncardiac surgery.
authors.affiliation: Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Science, Beijing 100730, China.
authors.forename: Zi-Jia
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Yu
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.forename: Jing-Mei
authors.initials: JM
authors.lastname: Jiang
authors.forename: Yu-Guang
authors.initials: YG
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000150:complications*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment