Critical values of monitoring indexes for perioperative major adverse cardiac events in elderly patients with biliary diseases

Zong-Ming Zhang; Xi-Yuan Xie; Yue Zhao; Chong Zhang; Zhuo Liu; Li-Min Liu; Ming-Wen Zhu; Bai-Jiang Wan; Hai Deng; Kun Tian; Zhen-Tian Guo; Xi-Zhe Zhao

doi:10.12998/wjcc.v10.i20.6865

Critical values of monitoring indexes for perioperative major adverse cardiac events in elderly patients with biliary diseases

World J Clin Cases. 2022 Jul 16;10(20):6865-6875. doi: 10.12998/wjcc.v10.i20.6865.

Authors

Affiliations

¹ Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China. zhangzongming@mail.tsinghua.edu.cn.
² Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China.
³ Department of Cardiology, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China.

Abstract

Background: Major adverse cardiac events (MACE) in elderly patients with biliary diseases are the main cause of perioperative accidental death, but no widely recognized quantitative monitoring index of perioperative cardiac function so far.

Aim: To investigate the critical values of monitoring indexes for perioperative MACE in elderly patients with biliary diseases.

Methods: The clinical data of 208 elderly patients with biliary diseases in our hospital from May 2016 to April 2021 were retrospectively analysed. According to whether MACE occurred during the perioperative period, they were divided into the MACE group and the non-MACE group.

Results: In the MACE compared with the non-MACE group, postoperative complications, mortality, hospital stay, high sensitivity troponin-I (Hs-TnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), B-type natriuretic peptide (BNP), and D-dimer (D-D) levels were significantly increased (P < 0.05). Multivariate logistic regression showed that postoperative BNP and D-D were independent risk factors for perioperative MACE, and their cut-off values in the receiver operating characteristic (ROC) curve were 382.65 pg/mL and 0.965 mg/L, respectively.

Conclusion: The postoperative BNP and D-D were independent risk factors for perioperative MACE, with the critical values of 382.65 pg/mL and 0.965 mg/L respectively. Consequently, timely monitoring and effective maintenance of perioperative cardiac function stability are of great clinical significance to further improve the perioperative safety of elderly patients with biliary diseases.

Keywords: Biliary diseases in elderly patients; Logistic regression; Major adverse cardiac events; Perioperative safety; Receiver operating characteristic curve.