Incidence and Predictors of Cardiac Complications Following Elective Versus Urgent Non-cardiac Surgeries.

Cardiac complications following non-cardiac surgeries are a significant cause of perioperative morbidity and mortality. This meta-analysis aimed to assess the incidence and predictors of cardiac complications in patients undergoing elective and urgent non-cardiac surgeries. A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library databases for studies published between 2010 and 2024. Eligible studies evaluated cardiac outcomes such as myocardial infarction, arrhythmias, congestive heart failure, and cardiac arrest, reporting odds ratios (ORs) and confidence intervals (CIs) for associated risk factors. A total of seven studies were included, encompassing data from diverse populations and surgical settings. The pooled analysis revealed an overall incidence of cardiac complications of 2.8% (95% CI = 2.1%-3.5%) in elective surgeries and 5.4% (95% CI = 4.0%-6.8%) in urgent surgeries. Urgent procedures were associated with a significantly higher risk of cardiac events compared to elective surgeries (OR = 1.42, 95% CI = 1.15-1.76). Independent predictors of cardiac complications included advanced age, preoperative comorbidities such as hypertension and diabetes, reduced left ventricular ejection fraction, and elevated preoperative cardiac biomarkers, such as troponin levels. Significant heterogeneity was observed across studies, largely attributed to variations in surgical populations and definitions of cardiac outcomes. Subgroup analyses demonstrated that age >75 years (OR = 1.50, 95% CI = 1.20-1.90) and emergency procedures in patients with pre-existing cardiovascular disease (OR = 1.75, 95% CI = 1.30-2.10) were critical determinants of adverse outcomes. Additionally, intraoperative hypotension and prolonged surgical duration were associated with increased risk. The findings underscore the need for comprehensive preoperative risk assessment and tailored perioperative management strategies to mitigate cardiac risk, particularly in high-risk patients undergoing urgent surgeries. Enhanced utilization of preoperative biomarkers and risk scoring systems, coupled with vigilant intraoperative monitoring, may help reduce the burden of cardiac complications. While improvements in perioperative care have mitigated some risks, disparities remain, especially in resource-limited settings, warranting further research.