Preoperative autonomic function abnormalities in patients with diabetes mellitus and patients with hypertension

M. E. Charlson, C. R. MacKenzie, Jeffrey P Gold

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND: This study was done to assess whether or not autonomic function abnormalities identified patients with diabetes mellitus as being at risk for postoperative cardiac arrest or death. STUDY DESIGN: We prospectively studied 74 patients with diabetes mellitus and 118 patients with hypertension without diabetes mellitus undergoing elective noncardiac operation. The study was done at an academic medical center between 1982 and 1985. Patients were evaluated preoperatively, monitored intraoperatively by an independent observer and had daily follow-up evaluation for seven days postoperatively, according to a standard surveillance protocol. Outcomes were judged by assessors unaware of the preoperative status and intraoperative course. Patients were interviewed at three and five years postoperatively. RESULTS: Patients with diabetes mellitus with two or more abnormal autonomic function test results did not experience more intraoperative hypotension, nor did they require more intraoperative pressor agents than patients with diabetes mellitus with one or no abnormalities. Seven percent of the patients with diabetes mellitus experienced postoperative cardiorespiratory arrest or death. All of these patients had more than two abnormal autonomic function test results as well as a previous history of either myocardial infarction or cardiomegaly. CONCLUSIONS: While this study obviously requires confirmation in a larger population, the data are sufficiently strong to warrant close postoperative monitoring of all patients with diabetes mellitus who have two or more autonomic abnormalities.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalJournal of the American College of Surgeons
Volume179
Issue number1
StatePublished - Jan 1 1994

Fingerprint

Diabetes Mellitus
Hypertension
Cardiomegaly
Physiologic Monitoring
Proxy
Heart Arrest
Hypotension
Myocardial Infarction
Population

ASJC Scopus subject areas

  • Surgery

Cite this

Preoperative autonomic function abnormalities in patients with diabetes mellitus and patients with hypertension. / Charlson, M. E.; MacKenzie, C. R.; Gold, Jeffrey P.

In: Journal of the American College of Surgeons, Vol. 179, No. 1, 01.01.1994, p. 1-10.

Research output: Contribution to journalArticle

@article{901e6c09d0c945e4ac31df3dbe1ca677,
title = "Preoperative autonomic function abnormalities in patients with diabetes mellitus and patients with hypertension",
abstract = "BACKGROUND: This study was done to assess whether or not autonomic function abnormalities identified patients with diabetes mellitus as being at risk for postoperative cardiac arrest or death. STUDY DESIGN: We prospectively studied 74 patients with diabetes mellitus and 118 patients with hypertension without diabetes mellitus undergoing elective noncardiac operation. The study was done at an academic medical center between 1982 and 1985. Patients were evaluated preoperatively, monitored intraoperatively by an independent observer and had daily follow-up evaluation for seven days postoperatively, according to a standard surveillance protocol. Outcomes were judged by assessors unaware of the preoperative status and intraoperative course. Patients were interviewed at three and five years postoperatively. RESULTS: Patients with diabetes mellitus with two or more abnormal autonomic function test results did not experience more intraoperative hypotension, nor did they require more intraoperative pressor agents than patients with diabetes mellitus with one or no abnormalities. Seven percent of the patients with diabetes mellitus experienced postoperative cardiorespiratory arrest or death. All of these patients had more than two abnormal autonomic function test results as well as a previous history of either myocardial infarction or cardiomegaly. CONCLUSIONS: While this study obviously requires confirmation in a larger population, the data are sufficiently strong to warrant close postoperative monitoring of all patients with diabetes mellitus who have two or more autonomic abnormalities.",
author = "Charlson, {M. E.} and MacKenzie, {C. R.} and Gold, {Jeffrey P}",
year = "1994",
month = "1",
day = "1",
language = "English (US)",
volume = "179",
pages = "1--10",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Preoperative autonomic function abnormalities in patients with diabetes mellitus and patients with hypertension

AU - Charlson, M. E.

AU - MacKenzie, C. R.

AU - Gold, Jeffrey P

PY - 1994/1/1

Y1 - 1994/1/1

N2 - BACKGROUND: This study was done to assess whether or not autonomic function abnormalities identified patients with diabetes mellitus as being at risk for postoperative cardiac arrest or death. STUDY DESIGN: We prospectively studied 74 patients with diabetes mellitus and 118 patients with hypertension without diabetes mellitus undergoing elective noncardiac operation. The study was done at an academic medical center between 1982 and 1985. Patients were evaluated preoperatively, monitored intraoperatively by an independent observer and had daily follow-up evaluation for seven days postoperatively, according to a standard surveillance protocol. Outcomes were judged by assessors unaware of the preoperative status and intraoperative course. Patients were interviewed at three and five years postoperatively. RESULTS: Patients with diabetes mellitus with two or more abnormal autonomic function test results did not experience more intraoperative hypotension, nor did they require more intraoperative pressor agents than patients with diabetes mellitus with one or no abnormalities. Seven percent of the patients with diabetes mellitus experienced postoperative cardiorespiratory arrest or death. All of these patients had more than two abnormal autonomic function test results as well as a previous history of either myocardial infarction or cardiomegaly. CONCLUSIONS: While this study obviously requires confirmation in a larger population, the data are sufficiently strong to warrant close postoperative monitoring of all patients with diabetes mellitus who have two or more autonomic abnormalities.

AB - BACKGROUND: This study was done to assess whether or not autonomic function abnormalities identified patients with diabetes mellitus as being at risk for postoperative cardiac arrest or death. STUDY DESIGN: We prospectively studied 74 patients with diabetes mellitus and 118 patients with hypertension without diabetes mellitus undergoing elective noncardiac operation. The study was done at an academic medical center between 1982 and 1985. Patients were evaluated preoperatively, monitored intraoperatively by an independent observer and had daily follow-up evaluation for seven days postoperatively, according to a standard surveillance protocol. Outcomes were judged by assessors unaware of the preoperative status and intraoperative course. Patients were interviewed at three and five years postoperatively. RESULTS: Patients with diabetes mellitus with two or more abnormal autonomic function test results did not experience more intraoperative hypotension, nor did they require more intraoperative pressor agents than patients with diabetes mellitus with one or no abnormalities. Seven percent of the patients with diabetes mellitus experienced postoperative cardiorespiratory arrest or death. All of these patients had more than two abnormal autonomic function test results as well as a previous history of either myocardial infarction or cardiomegaly. CONCLUSIONS: While this study obviously requires confirmation in a larger population, the data are sufficiently strong to warrant close postoperative monitoring of all patients with diabetes mellitus who have two or more autonomic abnormalities.

UR - http://www.scopus.com/inward/record.url?scp=0028346321&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028346321&partnerID=8YFLogxK

M3 - Article

VL - 179

SP - 1

EP - 10

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -