Risk for postoperative congestive heart failure

M. E. Charlson, C. R. MacKenzie, J. P. Gold, K. L. Ales, M. Topkins, G. T. Shires

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

To identify predictors of postoperative congestive heart failure (CHF), a high-risk population, mainly hypertensive and diabetic patients undergoing elective general operations, was studied. Of the 254 patients, 6 per cent had postoperative CHF. Among patients with preoperative cardiac disease (that is, previous myocardial infarction, valvular disease or CHF), 17 per cent had postoperative CHF; in contrast with less than 1 per cent of those without cardiac disease (p<0.001). Patients with diabetes were also at high risk (12 versus 2 per cent, p<0.005), particularly those with cardiac disease. Patients who had equal to or greater than 40 millimeters of mercury increases or decreases intraoperatively in mean arterial pressure in relation to preoperative baseline had increased postoperative failure rates (p<0.02). Of note, postoperative failure rates were highest among patients with less than 500 milliliters per hour of net intake (input and output) (p<0.03). Risk for postoperative CHF was restricted to patients with preoperative symptomatic cardiac disease and was especially high if patients also had diabetes. Intraoperative fluctuations in mean arterial pressure increased the probability of postoperative failure, while the intraoperative administration of higher net volumes of fluid was associated with decreased risk.

Original languageEnglish (US)
Pages (from-to)95-104
Number of pages10
JournalSurgery Gynecology and Obstetrics
Volume172
Issue number2
StatePublished - Jan 1 1991

Fingerprint

Heart Failure
Heart Diseases
Arterial Pressure
Mercury
Myocardial Infarction
Population

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

Cite this

Charlson, M. E., MacKenzie, C. R., Gold, J. P., Ales, K. L., Topkins, M., & Shires, G. T. (1991). Risk for postoperative congestive heart failure. Surgery Gynecology and Obstetrics, 172(2), 95-104.

Risk for postoperative congestive heart failure. / Charlson, M. E.; MacKenzie, C. R.; Gold, J. P.; Ales, K. L.; Topkins, M.; Shires, G. T.

In: Surgery Gynecology and Obstetrics, Vol. 172, No. 2, 01.01.1991, p. 95-104.

Research output: Contribution to journalArticle

Charlson, ME, MacKenzie, CR, Gold, JP, Ales, KL, Topkins, M & Shires, GT 1991, 'Risk for postoperative congestive heart failure', Surgery Gynecology and Obstetrics, vol. 172, no. 2, pp. 95-104.
Charlson ME, MacKenzie CR, Gold JP, Ales KL, Topkins M, Shires GT. Risk for postoperative congestive heart failure. Surgery Gynecology and Obstetrics. 1991 Jan 1;172(2):95-104.
Charlson, M. E. ; MacKenzie, C. R. ; Gold, J. P. ; Ales, K. L. ; Topkins, M. ; Shires, G. T. / Risk for postoperative congestive heart failure. In: Surgery Gynecology and Obstetrics. 1991 ; Vol. 172, No. 2. pp. 95-104.
@article{ad38abd41e0c4669a1bb32f0fc1bfacb,
title = "Risk for postoperative congestive heart failure",
abstract = "To identify predictors of postoperative congestive heart failure (CHF), a high-risk population, mainly hypertensive and diabetic patients undergoing elective general operations, was studied. Of the 254 patients, 6 per cent had postoperative CHF. Among patients with preoperative cardiac disease (that is, previous myocardial infarction, valvular disease or CHF), 17 per cent had postoperative CHF; in contrast with less than 1 per cent of those without cardiac disease (p<0.001). Patients with diabetes were also at high risk (12 versus 2 per cent, p<0.005), particularly those with cardiac disease. Patients who had equal to or greater than 40 millimeters of mercury increases or decreases intraoperatively in mean arterial pressure in relation to preoperative baseline had increased postoperative failure rates (p<0.02). Of note, postoperative failure rates were highest among patients with less than 500 milliliters per hour of net intake (input and output) (p<0.03). Risk for postoperative CHF was restricted to patients with preoperative symptomatic cardiac disease and was especially high if patients also had diabetes. Intraoperative fluctuations in mean arterial pressure increased the probability of postoperative failure, while the intraoperative administration of higher net volumes of fluid was associated with decreased risk.",
author = "Charlson, {M. E.} and MacKenzie, {C. R.} and Gold, {J. P.} and Ales, {K. L.} and M. Topkins and Shires, {G. T.}",
year = "1991",
month = "1",
day = "1",
language = "English (US)",
volume = "172",
pages = "95--104",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Risk for postoperative congestive heart failure

AU - Charlson, M. E.

AU - MacKenzie, C. R.

AU - Gold, J. P.

AU - Ales, K. L.

AU - Topkins, M.

AU - Shires, G. T.

PY - 1991/1/1

Y1 - 1991/1/1

N2 - To identify predictors of postoperative congestive heart failure (CHF), a high-risk population, mainly hypertensive and diabetic patients undergoing elective general operations, was studied. Of the 254 patients, 6 per cent had postoperative CHF. Among patients with preoperative cardiac disease (that is, previous myocardial infarction, valvular disease or CHF), 17 per cent had postoperative CHF; in contrast with less than 1 per cent of those without cardiac disease (p<0.001). Patients with diabetes were also at high risk (12 versus 2 per cent, p<0.005), particularly those with cardiac disease. Patients who had equal to or greater than 40 millimeters of mercury increases or decreases intraoperatively in mean arterial pressure in relation to preoperative baseline had increased postoperative failure rates (p<0.02). Of note, postoperative failure rates were highest among patients with less than 500 milliliters per hour of net intake (input and output) (p<0.03). Risk for postoperative CHF was restricted to patients with preoperative symptomatic cardiac disease and was especially high if patients also had diabetes. Intraoperative fluctuations in mean arterial pressure increased the probability of postoperative failure, while the intraoperative administration of higher net volumes of fluid was associated with decreased risk.

AB - To identify predictors of postoperative congestive heart failure (CHF), a high-risk population, mainly hypertensive and diabetic patients undergoing elective general operations, was studied. Of the 254 patients, 6 per cent had postoperative CHF. Among patients with preoperative cardiac disease (that is, previous myocardial infarction, valvular disease or CHF), 17 per cent had postoperative CHF; in contrast with less than 1 per cent of those without cardiac disease (p<0.001). Patients with diabetes were also at high risk (12 versus 2 per cent, p<0.005), particularly those with cardiac disease. Patients who had equal to or greater than 40 millimeters of mercury increases or decreases intraoperatively in mean arterial pressure in relation to preoperative baseline had increased postoperative failure rates (p<0.02). Of note, postoperative failure rates were highest among patients with less than 500 milliliters per hour of net intake (input and output) (p<0.03). Risk for postoperative CHF was restricted to patients with preoperative symptomatic cardiac disease and was especially high if patients also had diabetes. Intraoperative fluctuations in mean arterial pressure increased the probability of postoperative failure, while the intraoperative administration of higher net volumes of fluid was associated with decreased risk.

UR - http://www.scopus.com/inward/record.url?scp=0026022512&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026022512&partnerID=8YFLogxK

M3 - Article

C2 - 1989124

AN - SCOPUS:0026022512

VL - 172

SP - 95

EP - 104

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 2

ER -