Prevalence and trends of perioperative major adverse cardiovascular and cerebrovascular events during cancer surgeries

Major adverse cardiovascular and cerebrovascular events (MACCE) is an important cause of morbidity and mortality during perioperative period. In this study, we looked for national trends in perioperative MACCE and its components as well as cancer types associated with high rates of perioperative MACCE during major cancer surgeries. This study was a retrospective analysis of the National Inpatient Sample, 2005-2014. Hospitalizations for surgeries of prostate, bladder, esophagus, pancreas, lung, liver, colorectal, and breast among patients 40 years and greater were included in the analysis. MACCE was defined as a composite measure that included in-hospital all-cause mortality, acute myocardial infarction (AMI), and ischemic stroke. A total of 2,854,810 hospitalizations for major surgeries were included in this study. Of these, 67,316 (2.4%) had perioperative MACCE. Trends of perioperative MACCE showed that it decreased significantly for AMI, death and any MACCE, while stroke did not significantly change during the study period. Logistic regression analysis for perioperative MACCE by cancer types showed that surgeries for esophagus, pancreas, lung, liver, and colorectal cancers had significantly greater odds for perioperative MACCE. The surgeries identified to have greater risks for MACCE in this study could be risk stratified for better informed decision-making and management.

Automated summary

Major adverse cardiovascular and cerebrovascular events (MACCE) are a significant cause of morbidity and mortality during the perioperative period. This study aimed to identify national trends in perioperative MACCE and its components, as well as the types of cancer surgeries associated with high rates of perioperative MACCE. A retrospective analysis of the National Inpatient Sample, from 2005 to 2014, was conducted, including hospitalizations for major surgeries of various cancers. The results showed a significant decrease in perioperative MACCE for acute myocardial infarction and death, while stroke did not significantly change. Logistic regression analysis identified esophageal, pancreatic, lung, liver, and colorectal cancers as having significantly higher odds of perioperative MACCE. These findings can contribute to risk stratification and better decision-making for high-risk surgeries.