Avaliação de parâmetros do perfil cardiológico de pacientes submetidos a cirurgia ortopédica em hospital terciário de Goiás e análise dos fatores associados a complicações no perioperatório

Nassandro Júnior Machado Garcia; Tailliny Jesus Reis; Giulliano Gardenghi; Luciana Fernandes Balestra

doi:10.63162/v66n67e25535

Authors

Nassandro Júnior Machado Garcia Hospital ENCORE, Aparecida de Goiânia/GO, Brasil ; Hospital de Urgências de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0008-8931-3842
Tailliny Jesus Reis Hospital de Urgências de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0000-0002-6202-9007
Giulliano Gardenghi Hospital de Urgências de Goiás, Goiânia/GO, Brasil ; Centro de Ensino e Treinamento da Clínica de Anestesia (CET - CLIANEST), Goiânia/GO, Brasil. Autor https://orcid.org/0000-0002-8763-561X
Luciana Fernandes Balestra Hospital de Urgências de Goiás, Goiânia/GO, Brasil ; Hospital do Coração Anis Rassi, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0006-0123-357X

DOI:

https://doi.org/10.63162/v66n67e25535

Keywords:

Perioperative care, Risk, Femoral fractures, Cardiology, Indica tors of Morbidity and Mortality

Abstract

Introduction: Perioperative cardiovascular assessment aims to identify increased risk of complications and adjust preventive measures. Physical limitations and the need for a rapid approach to the orthopedic patient restrict stratification. Objective: To evaluate the association between electrocardiographic (ECG) and laboratory changes, increased cardiovascular structures on chest radiography, length of hospital stay and high levels of morbidity and mortality. Objective: To evaluate the association between electrocardiographic and laboratory alterations, increased cardiovascular structures on chest radiographs, length of hospital stay, and high levels of morbidity and mortality. Methods: Patients underwent detailed history taking and physical examination. The risk profile was determined using the Multicenter Study for Perioperative Evaluation (EMAPO). Electrocardiographic alterations included blocks, presence of pathological Q waves, QRS > 150 ms, presence of atrial fibrillation and other arrhythmias. Analysis of chest radiographs determined the cardiothoracic ratio and the presence of mediastinal widening. Postoperative complications were considered as in-hospital death or length of hospital stay longer than 7 days and assessed using the Postoperative Morbidity Survey (POMS). Results: Eighty patients with a mean age of 79 years (54 to 100 years) were included, 46 of whom were women (57.5%). The overall mortality rate was 11.2% (14 deaths). The presence of isolated atrial and/or ventricular extrasystoles on the ECG (p = 0.000), advanced age (p = 0.001), reduced glomerular filtration rate (p = 0.002), length of hospital stay in the postoperative period (p =0.000), EMAPO score with moderate to high risk (p = 0.011) and POMS score with involvement of sites other than cardiac decompensation (p = 0.001) were statistically significant, considering mortality. The mortality rate among those operated was 8.7%, and no patient died during the operation. Of all patients, 48.8% had decompensation in the perioperative period, the majority of which were nosocomial infections. Conclusion: The patient’s clinical stability and the speed of surgical procedure are related to a better outcome. Conduction disturbances on the ECG, except for total atrioventricular block, as well as changes in the cardiac area and mediastinum were not associated with complications and do not suggest the need for progression in the investigation for surgical release

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