title: Impact of metabolic syndrome in surgical patients: should we bother?
abstract: Clinicians inevitably encounter patients who meet the diagnostic criteria for the metabolic syndrome (MetS); these criteria include central obesity, hypertension, atherogenic dyslipidaemia, and hyperglycaemia. Regardless of the variations in its definition, MetS may be associated with adverse outcomes in patients undergoing both cardiac and non-cardiac surgery. There is a paucity of data concerning the anaesthetic management of patients with MetS, and only a few observational (mainly retrospective) studies have investigated the association of MetS with perioperative outcomes. In this narrative review, we consider the impact of MetS on the occurrence of perioperative adverse events after cardiac and non-cardiac surgery. Metabolic syndrome has been associated with higher rates of cardiovascular, pulmonary, and renal perioperative events and wound infections compared with patients with a non-MetS profile. Metabolic syndrome has also been related to increased health service costs, prolonged hospital stay, and a greater need for posthospitalization care. Therefore, physicians should be able to recognize the MetS in the perioperative period in order to formulate management strategies that may modify any perianaesthetic and surgical risk. However, further research is needed in this field.
authors.affiliation: Department of Anaesthesia and Postoperative Intensive Care, School of Medicine, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece petzimas@gmail.com ptzimas@cc.uoi.gr.
authors.forename: P
authors.initials: P
authors.lastname: Tzimas
authors.affiliation: Department of Anaesthesia and Postoperative Intensive Care, School of Medicine, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Petrou
authors.affiliation: Department of Anaesthesia and Postoperative Intensive Care, School of Medicine, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Laou
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
authors.forename: H
authors.initials: H
authors.lastname: Milionis
authors.affiliation: Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Mikhailidis
authors.affiliation: Department of Anaesthesia and Postoperative Intensive Care, School of Medicine, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Papadopoulos
mesh_terms: D000758:Anesthesia / Q000379:methods; D001281:Atrial Fibrillation / Q000209:etiology; D050110:Bariatric Surgery / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D009017:Morbidity; D019637:Orthopedic Procedures / Q000009:adverse effects; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects
keywords: anaesthesia; metabolic syndrome; postoperative outcome; surgical procedures