title: Incidence and predictors of 30-day cardiovascular complications in patients undergoing head and neck cancer surgery.
abstract: Incidence and predictors of peri-operative or post-operative cardiovascular complications in head and neck cancer surgery remain poorly elucidated. In this retrospective study, we investigated the rate and pre-operative risk factors for cardiovascular and cerebrovascular complications. This study included all patients (n = 456) operated for head and neck cancer between 1999 and 2008. Patients' medical records were reviewed and the adjudication of endpoints was performed by adjudication committee. The 30-day incidence of cardiovascular and cerebrovascular complications was 7.2 %. Cardiac mortality at 30 days was 1.0 %. Univariate predictors of MACCE (major adverse cardiac and cerebrovascular events) at the 30-day follow-up were history of myocardial infarction (OR 4.56, 95 % CI 1.73-11.97, p = 0.002); history of heart failure (OR 4.14, 95 % CI 1.32-13.02, p = 0.015); pre-existing coronary artery disease (OR 3.98, 95 % CI 1.75-9.06, p = 0.001); prior aspirin medication (OR 3.73, 95 % CI 1.81-7.71, p < 0.001); prior betablocker medication (OR 3.67, 95 % CI 1.79-7.51, p < 0.001); hypertension (OR 2.55, 95 % CI 1.25-5.19, p = 0.010); and increasing age (OR 1.08, 95 % CI 1.05-1.12, p < 0.001). In a multivariate model, independent predictors of MACCE were pre-existing coronary artery disease (OR 2.45, 95 % CI 1.03-5.80, p = 0.042) and increasing age (OR 1.08, 95 % CI 1.04-1.11, p < 0.001). Patients having surgery for head and neck cancer are at high (>5 %) risk of developing vascular complications. Prior coronary artery disease and increasing age are independent risk factors for MACCE.
authors.affiliation: Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland. eeva.haapio@tyks.fi.
authors.forename: Eeva
authors.identifier: http://orcid.org/0000-0002-3349-6829
authors.initials: E
authors.lastname: Haapio
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Kiviniemi
authors.affiliation: Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Irjala
authors.affiliation: Department of Otorhinolaryngology, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Koivunen
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: J K E
authors.initials: JKE
authors.lastname: Airaksinen
authors.affiliation: Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Kinnunen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Acute coronary syndrome; Cardiovascular complication; Head and neck cancer; Heart failure; Pre-operative