For a study, the researchers sought to compare the outcomes of HF patients with reduced versus preserved ejection fractions after noncardiac surgery. Compared with the general population, HF patients who undergo major noncardiac surgery had a greater risk of morbidity and mortality. However, it was uncertain whether HF subtypes were associated with varying levels of risk. The Nationwide Readmissions Database comprised HF patients 45 years or older who underwent noncardiac surgery between January 1, 2010, and September 30, 2015. Adjusted rates of postoperative outcomes were calculated using multivariable logistic regression models. All models were run with hospital-level clustering and sampling weights from the National Readmissions Database. Furthermore, 41.1% had cardiopulmonary complications, 55.7% had noncardiopulmonary complications, and 5.4% died during hospitalization of the weighted 296,057 HF patients [HF with reduced ejection fraction (HFrEF) 48.%1; HF with preserved ejection fraction (HFpEF) 51.9%] who underwent noncardiac surgery. The weighted 30-day readmission rate for 232,852 HF patients was 21.5%. HFrEF patients had adjusted odds ratios of 1.01 [95% confidence interval (CI), 0.99–1.04], 1.05 (95% CI, 1.02–1.07), 1.27 (95% CI, 1.21–1.34), and 1.08 (95% CI, 1.05–1.12) for cardiopulmonary and noncardiopulmonary complications, in-hospital mortality, and 30-day readmission, respectively, when compared to HFpEF patients. Noncardiopulmonary complications, death, and readmission following noncardiac surgery were all higher in HFrEF patients. The data showed that for the expanding proportion of HF patients undergoing noncardiac surgery, tailored perioperative therapy for HF subtypes might have been critical. Even though there were no statistical differences across HF subtypes in terms of cardiopulmonary consequences, any intervention to reduce the risk would have been clinically significant considering the high occurrence rate.

 

Source:journals.lww.com/annalsofsurgery/Abstract/2022/04000/Comparison_of_Perioperative_Outcomes_in_Heart.27.aspx