[Postoperative cardiovascular complications].

BACKGROUND

It has been estimated that up to 25% of non-cardiac surgical procedures carry a significant risk of perioperative cardiovascular morbidity and mortality. A thorough preoperative evaluation with subsequent relevant diagnostic or therapeutic action can reduce the risk of postoperative complications in high-risk patients. The purpose of the present study was to compare clinical practice in a medium-sized Norwegian hospital with international recommendations regarding perioperative evaluation and care.

PATIENTS AND METHODS

We performed a registration of all patients transferred to the coronary care unit after surgery--retrospectively for 2002, prospectively for 2003.

RESULTS

A total of 55 patients with one or more postoperative complication were identified, out of which 28 had been through elective surgery. Forty-four of the patients suffered an acute myocardial infarction. At 30 days, 15 of the patients had died and a further 13 had sequelae. At 90 days, 22 patients were dead. The patients with complications were characterised by advanced age and high risk of cardiovascular disease. Out of the 55 patients, 8 were incorrectly scored for preoperative risk with American Society of Anaesthesiology's system for classification. For another 3, the score was missing. At discharge from the coronary care unit, only 1 out of 55 patients received a diagnosis of a postoperative complication.

INTERPRETATION

The registration indicates that there is a potential for improving clinical practice in order to reduce the number of postoperative complications.